Provider Demographics
NPI:1528953460
Name:FOX, BRIANNA LYNN
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
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 1:4075 HOLT RD LOT 265
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-6008
Mailing Address - Country:US
Mailing Address - Phone:813-860-1533
Mailing Address - Fax:
Practice Address - Street 1:5770 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1877
Practice Address - Country:US
Practice Address - Phone:248-301-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker