Provider Demographics
NPI:1790178283
Name:FOX, DANIELLE CRISTINE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CRISTINE
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 SEQUOIA LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7284
Mailing Address - Country:US
Mailing Address - Phone:989-915-2808
Mailing Address - Fax:
Practice Address - Street 1:2715 S TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-9294
Practice Address - Country:US
Practice Address - Phone:989-366-8550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker