Provider Demographics
NPI:1295334787
Name:FOX, RYANE M
Entity type:Individual
Prefix:
First Name:RYANE
Middle Name:M
Last Name:FOX
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 1:231 GARRISONVILLE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1603
Mailing Address - Country:US
Mailing Address - Phone:540-699-2381
Mailing Address - Fax:540-301-2788
Practice Address - Street 1:231 GARRISONVILLE RD STE 205
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1603
Practice Address - Country:US
Practice Address - Phone:540-699-2381
Practice Address - Fax:540-301-2788
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-20-128916OtherBACB