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General NPI Number Information
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NPI Number | 1164000436
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Entity Type | Individual
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Provider Name | CAMILLE H FOX
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 24 JOE KENNEDY BLVD STE 13
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City | STATESBORO
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State | GA
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Zip | 30458
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Country | US
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Telephone | 912-208-2024
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Fax |
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Provider Business Mailing Address
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Address Line | 2805 S INDUSTRIAL HWY STE 100
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City | ANN ARBOR
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State | MI
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Zip | 48104-6791
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-77357
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License Number State | GA
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