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General NPI Number Information
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NPI Number | 1528578937
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Entity Type | Individual
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Provider Name | SHELBY KAY FOX
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Gender | Female
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 3508 S WYMAN RD
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City | REMUS
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State | MI
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Zip | 49340-9603
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Country | US
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Telephone | 989-317-7553
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Fax |
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Provider Business Mailing Address
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Address Line | 11646 S WINN RD
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City | VESTABURG
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State | MI
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Zip | 48891-9600
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Country | US
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Telephone | 989-866-6539
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BACB607169
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License Number State | MI
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