Healthcare Provider Details
I. General information
NPI: 1851218291
Provider Name (Legal Business Name): KELLY ANN FOX LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1105 TAYLORSVILLE RD STE 315
WASHINGTON CROSSING PA
18977-1158
US
IV. Provider business mailing address
1094 LITTLE RD
WASHINGTON CROSSING PA
18977-1314
US
V. Phone/Fax
- Phone: 215-622-5192
- Fax:
- Phone: 215-622-5192
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | 20357 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | MSG006611 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: