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General NPI Number Information
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NPI Number | 1376531442
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Entity Type | Individual
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Provider Name | KATHLEEN FOX LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5 S MAIN ST SUITE 514
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City | BRANFORD
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State | CT
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Zip | 06405-3800
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Country | US
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Telephone | 203-481-2887
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Fax | 203-488-1303
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Provider Business Mailing Address
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Address Line | 5 S MAIN ST SUITE 514
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City | BRANFORD
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State | CT
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Zip | 06405-3800
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Country | US
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Telephone | 203-481-2887
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Fax | 203-488-1303
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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 | 000563
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License Number State | CT
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