Individual
NICHOLE DAWN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS, CADC-R
Contact information
Practice address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
(541) 858-7593
Mailing address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
(541) 734-2410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1388
OR
247000000X
Health Information Technician
—
—
Other
Enumeration date
03/10/2016
Last updated
12/21/2022
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