Provider Demographics
NPI:1528823283
Name:FOX, ANDRES I
Entity type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:
Last Name:FOX
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9379 SIR BRUTUS RUN
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-6919
Mailing Address - Country:US
Mailing Address - Phone:251-767-0637
Mailing Address - Fax:
Practice Address - Street 1:9379 SIR BRUTUS RUN
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-6919
Practice Address - Country:US
Practice Address - Phone:251-767-0637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty