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NPI 1326797226

NPI 1326797226 : SHELLY NOELLE FOX MA : FLOYD, VA

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General NPI Number Information
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    NPI Number           |    1326797226
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    Entity Type          |    Individual 
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    Provider Name        |    SHELLY NOELLE FOX MA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2022
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    Last Update Date     |    03/20/2022
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Provider Practice Location Address
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    Address Line         |    401 S LOCUST ST 
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    City                 |    FLOYD
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    State                |    VA
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    Zip                  |    24091-2323
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    Country              |    US
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    Telephone            |    540-501-7169
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    Fax                  |    540-745-4706
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Provider Business Mailing Address
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    Address Line         |    PO BOX 975 
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    City                 |    FLOYD
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    State                |    VA
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    Zip                  |    24091-0975
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    Country              |    US
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    Telephone            |    540-501-7169
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    Fax                  |    540-745-4706
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    0704014663
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    License Number State |    VA
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