Individual
MS. KELLY ANN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-5751
(608) 417-5315
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5239-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811286859
—
WI
Enumeration date
03/30/2011
Last updated
09/13/2022
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