Provider Demographics
NPI:1689373466
Name:FOX, DONALD D (MED, BCBA, LBA)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:D
Last Name:FOX
Suffix:
Gender:M
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 INDIGO LN
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-4475
Mailing Address - Country:US
Mailing Address - Phone:802-598-3970
Mailing Address - Fax:
Practice Address - Street 1:44 INDIGO LN
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-4475
Practice Address - Country:US
Practice Address - Phone:802-598-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT146.0134249103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst