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General NPI Number Information
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NPI Number | 1255209367
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Entity Type | Individual
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Provider Name | TIFFANY FOX, FOX
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Gender | Female
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 5268 GODWIN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23434-8114
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Country | US
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Telephone | 757-255-7133
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Fax |
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Provider Business Mailing Address
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Address Line | 132 LONG BRIDGE WAY APT F
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-8431
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Country | US
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Telephone | 757-793-1402
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904019385
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License Number State | VA
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