Provider Demographics
NPI:1750658852
Name:FOX, CASSIE RAE (BC-HIS)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:RAE
Last Name:FOX
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 N MAYO TRL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-2966
Mailing Address - Country:US
Mailing Address - Phone:606-437-7703
Mailing Address - Fax:606-437-7782
Practice Address - Street 1:5425 N MAYO TRL
Practice Address - Street 2:SUITE 201
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2966
Practice Address - Country:US
Practice Address - Phone:606-437-7703
Practice Address - Fax:606-437-7782
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0915237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist