Provider Demographics
NPI:1649581422
Name:FOX SPEECH THERAPY
Entity Type:Organization
Organization Name:FOX SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD CCC-SLP
Authorized Official - Phone:540-446-2654
Mailing Address - Street 1:200 EXECUTIVE CENTER PARKWAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401
Mailing Address - Country:US
Mailing Address - Phone:540-446-2654
Mailing Address - Fax:540-993-1081
Practice Address - Street 1:200 EXECUTIVE CENTER PARKWAY
Practice Address - Street 2:SUITE 106
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-446-2654
Practice Address - Fax:540-993-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004724225X00000X
VA2202005910235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty