Provider Demographics
NPI:1811255839
Name:FOX, LISA DIANE (BS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:DIANE
Last Name:FOX
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Gender:F
Credentials:BS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5231 PENN AVE
Mailing Address - Street 2:2ND FLOOR, ROOM 221
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1768
Mailing Address - Country:US
Mailing Address - Phone:412-204-9061
Mailing Address - Fax:412-204-9134
Practice Address - Street 1:5231 PENN AVE
Practice Address - Street 2:2ND FLOOR, ROOM 221
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1768
Practice Address - Country:US
Practice Address - Phone:412-204-9061
Practice Address - Fax:412-204-9134
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health