Healthcare Provider Details

I. General information

NPI: 1700048519
Provider Name (Legal Business Name): PATRICE FOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 STAGECOACH RD
UNITY ME
04988-4116
US

IV. Provider business mailing address

216 STAGECOACH RD
UNITY ME
04988-4116
US

V. Phone/Fax

Practice location:
  • Phone: 207-948-2899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT373
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: