Provider Demographics
NPI:1245011345
Name:COX, AUDRA JEAN
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:JEAN
Last Name:COX
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 1:5912 E STATE ROAD 168
Mailing Address - Street 2:
Mailing Address - City:FORT BRANCH
Mailing Address - State:IN
Mailing Address - Zip Code:47648-8566
Mailing Address - Country:US
Mailing Address - Phone:812-664-2745
Mailing Address - Fax:
Practice Address - Street 1:5912 E STATE ROAD 168
Practice Address - Street 2:
Practice Address - City:FORT BRANCH
Practice Address - State:IN
Practice Address - Zip Code:47648-8566
Practice Address - Country:US
Practice Address - Phone:812-664-2745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist