Provider Demographics
NPI:1124775911
Name:FOX, MARIA T (REGISTERED ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:FOX
Suffix:
Gender:F
Credentials:REGISTERED ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23443 SW RICHEN PARK TER
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8378
Mailing Address - Country:US
Mailing Address - Phone:503-515-9390
Mailing Address - Fax:
Practice Address - Street 1:9370 SW GREENBURG RD STE 321
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5421
Practice Address - Country:US
Practice Address - Phone:503-770-0503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7417101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health