Fox, Tara
Fox, Tara is an sole proprietor health care provider with primary practice located at 156 Shadow Wood Bnd , St Simons Island GA 31522-5713. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Fox, Tara can be contacted via phone (678) 333-5832.Contact Information
Primary practice address
156 Shadow Wood Bnd
St Simons Island GA 31522-5713
Phone: (678) 333-5832
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OT 11705 | Florida |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OT004571 | Georgia |
Profile Details
| NPI number | 1588654537 |
|---|---|
| LBN Legal business name | Fox, Tara |
| Credentials | MOT OTRL |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 21st, 2005 |
| Last updated | May 23rd, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588654537 | NPPES |
| Florida | MEDICAID | 890417100 |
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