Provider Demographics
NPI:1255579538
Name:FOX, GLORIA (MSLPC)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MSLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-4705
Mailing Address - Country:US
Mailing Address - Phone:302-377-8436
Mailing Address - Fax:
Practice Address - Street 1:515 W 18TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4705
Practice Address - Country:US
Practice Address - Phone:302-377-8436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional