Individual
TRAVAE FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCHW
Contact information
Practice address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 251-6409
Mailing address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 251-6409
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F200802001552
—
MI
Enumeration date
07/19/2022
Last updated
08/04/2022
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