Provider Demographics
NPI:1790251429
Name:FOX, LINDSEY MICHELLE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELLE
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 1:20 W LUCERNE CIR APT 811
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3704
Mailing Address - Country:US
Mailing Address - Phone:561-927-7591
Mailing Address - Fax:
Practice Address - Street 1:20 W LUCERNE CIR APT 811
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3704
Practice Address - Country:US
Practice Address - Phone:561-927-7591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-20
Last Update Date:2018-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician