Provider Demographics
NPI:1427508555
Name:FOX, ANGLEA LENIECE
Entity type:Individual
Prefix:
First Name:ANGLEA
Middle Name:LENIECE
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6012 EDMUND ST
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-4449
Mailing Address - Country:US
Mailing Address - Phone:313-623-2274
Mailing Address - Fax:
Practice Address - Street 1:6012 EDMUND ST
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-4449
Practice Address - Country:US
Practice Address - Phone:313-623-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other