Provider Demographics
NPI:1760101760
Name:COX, RANDY JAMES
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:JAMES
Last Name:COX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10159 S SOLSTICE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COPPERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84006-1209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3784 W VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILLS
Practice Address - State:UT
Practice Address - Zip Code:84062-8085
Practice Address - Country:US
Practice Address - Phone:801-401-9998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11513651-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist