Healthcare Provider Details

I. General information

NPI: 1538933197
Provider Name (Legal Business Name): CHE ALEXA-RAE FOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 WEST ST # 201
ANNAPOLIS MD
21401-3954
US

IV. Provider business mailing address

1500 S DOUGLAS RD STE 230
CORAL GABLES FL
33134-4108
US

V. Phone/Fax

Practice location:
  • Phone: 410-673-4965
  • Fax:
Mailing address:
  • Phone: 844-854-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-316323
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: