Provider Demographics
NPI:1851001895
Name:FOX, JENIFER JOYE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:JOYE
Last Name:FOX
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 FOX RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-8679
Mailing Address - Country:US
Mailing Address - Phone:269-760-4641
Mailing Address - Fax:
Practice Address - Street 1:1753 FOX RIDGE TRL
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-8679
Practice Address - Country:US
Practice Address - Phone:269-760-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61372634235Z00000X
MI7101000046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist