MEDICARE: LISA DIONNE FOX MED, BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-14-17664	TN
2	103K00000X	Behavior Analyst	BACB26127	TN

General Provider Information

NPI Number	:	1922496843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA DIONNE FOX MED, BCBA

Provider Business Mailing Address
First Line	:	7183 GOLDENROD CT
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-5673
Country	:	US
Telephone Number	:	615-881-1203
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W. MARTIN LUTHER KING BLVD
Second Line	:	SUITE 1000
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2571
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:	772-675-9100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2014
Last Update Date	:	10/13/2025

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