Provider Demographics
NPI:1619567427
Name:COX, JILL E (MS)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:E
Last Name:COX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ROCKING CHAIR LN
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:NC
Mailing Address - Zip Code:28748-6615
Mailing Address - Country:US
Mailing Address - Phone:813-422-2410
Mailing Address - Fax:
Practice Address - Street 1:16 ROCKING CHAIR LN
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:NC
Practice Address - Zip Code:28748-6615
Practice Address - Country:US
Practice Address - Phone:813-422-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15015101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional