Provider Demographics
NPI:1609130848
Name:FOX, HATTIE-ANGELYS I (MS ED/ SP ED)
Entity type:Individual
Prefix:MRS
First Name:HATTIE-ANGELYS
Middle Name:I
Last Name:FOX
Suffix:
Gender:
Credentials:MS ED/ SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4809
Mailing Address - Country:US
Mailing Address - Phone:631-236-8774
Mailing Address - Fax:
Practice Address - Street 1:2160 SANDY DR STE D
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2205
Practice Address - Country:US
Practice Address - Phone:814-380-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000439-01103K00000X
PABH007695103K00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17OtherSPECIALIST