Individual
DOUGLAS FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1621 LEGEND HILL LN, WAUKESHA, WI 53189-8085
(262) 524-8522
Mailing address
1621 LEGEND HILL LN, WAUKESHA, WI 53189-8085
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42732400
—
WI
Enumeration date
05/04/2008
Last updated
05/04/2008
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