Provider Demographics
NPI:1780787259
Name:FOX, PATRICIA C (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:C
Last Name:FOX
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:VAMHCS
Mailing Address - Street 2:PP116 MHCC
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21902
Mailing Address - Country:US
Mailing Address - Phone:800-949-1003
Mailing Address - Fax:
Practice Address - Street 1:PP116 MHCC
Practice Address - Street 2:VA MARYLAND HEALTH CARE SYSTEM
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:800-949-1003
Practice Address - Fax:410-642-1101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01507103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical