Provider Demographics
NPI:1245467497
Name:FOX, TIFFANY D (BSN, MBA)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:D
Last Name:FOX
Suffix:
Gender:
Credentials:BSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 COLTRAIN RD APT B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2738
Mailing Address - Country:US
Mailing Address - Phone:336-358-7854
Mailing Address - Fax:
Practice Address - Street 1:121 S ELM ST STE 13
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2792
Practice Address - Country:US
Practice Address - Phone:336-937-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251S00000XAgenciesCommunity/Behavioral Health