MEDICARE: DANA FOX PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP2848	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033253570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA FOX PH.D.

Provider Business Mailing Address
First Line	:	821 RAYMOND AVE STE 220
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1525
Country	:	US
Telephone Number	:	612-605-6575
Fax Number	:

Provider Business Practice Location Address
First Line	:	821 RAYMOND AVE STE 220
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1525
Country	:	US
Telephone Number	:	612-605-6575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2007
Last Update Date	:	01/23/2019

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Directions to “ DANA FOX PH.D.” Practice Location

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