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Individual

DIANA FOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
482 S LANDMARK AVE, BLOOMINGTON, IN 47403-5000
(812) 679-6130
Mailing address
482 S LANDMARK AVE, BLOOMINGTON, IN 47403-5000

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99107601A
IN

Other

Enumeration date
02/23/2022
Last updated
02/23/2022
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