Provider Demographics
NPI:1689004301
Name:FOX, JULIE (MA, CCC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13900 BUBBLING SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73150-8329
Mailing Address - Country:US
Mailing Address - Phone:361-876-3749
Mailing Address - Fax:
Practice Address - Street 1:13900 BUBBLING SPRINGS CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73150-8329
Practice Address - Country:US
Practice Address - Phone:361-876-3749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4009235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist