Provider Demographics
NPI:1194134700
Name:FOX, SCOTT W (MA,CCC/SLP)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:FOX
Suffix:
Gender:M
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5989 MEIJER DR STE 4
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1544
Mailing Address - Country:US
Mailing Address - Phone:513-575-5431
Mailing Address - Fax:
Practice Address - Street 1:5989 MEIJER DR STE 4
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1544
Practice Address - Country:US
Practice Address - Phone:513-575-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-5748235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist