Provider Demographics
NPI:1770244378
Name:FOX SPEECH AND LANGUAGE PLLC
Entity Type:Organization
Organization Name:FOX SPEECH AND LANGUAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-239-5850
Mailing Address - Street 1:2520 SOUTH BLVD APT 418
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-6654
Mailing Address - Country:US
Mailing Address - Phone:336-239-5850
Mailing Address - Fax:
Practice Address - Street 1:2520 SOUTH BLVD APT 418
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-6654
Practice Address - Country:US
Practice Address - Phone:336-239-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2330585OtherSOSID