Provider Demographics
NPI:1922091586
Name:COX, C YVONNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:YVONNE
Last Name:COX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31768-5508
Mailing Address - Country:US
Mailing Address - Phone:229-985-8452
Mailing Address - Fax:229-890-8430
Practice Address - Street 1:600 1ST ST SE
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-5508
Practice Address - Country:US
Practice Address - Phone:229-985-8452
Practice Address - Fax:229-890-8430
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional