Healthcare Provider Details

I. General information

NPI: 1841026135
Provider Name (Legal Business Name): KATHY JEANNE FOX LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CIRCLE DR STE 12
NORTH LIBERTY IA
52317-8818
US

IV. Provider business mailing address

1309 LEGEND DR
TIFFIN IA
52340-1301
US

V. Phone/Fax

Practice location:
  • Phone: 319-505-8225
  • Fax:
Mailing address:
  • Phone: 319-505-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number124736
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: