Provider Demographics
NPI:1841026135
Name:FOX, KATHY (MA-MFT, TLMFT)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MA-MFT, TLMFT
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:NOFTSGER LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1309 LEGEND DR
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:IA
Mailing Address - Zip Code:52340-1301
Mailing Address - Country:US
Mailing Address - Phone:563-940-7725
Mailing Address - Fax:
Practice Address - Street 1:1811 BOYSON RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1386
Practice Address - Country:US
Practice Address - Phone:319-250-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA124736106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist