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Shelly Rae Fox
Peer Specialist in Grand Ronde, Oregon
NPI 1619664711

Shelly Rae Fox is a Peer Specialist based in Grand Ronde, OR. Shelly Rae Fox practices in Grand Ronde, OR. The NPI Number for Shelly Rae Fox is 1619664711 and holds a License No. THW000108778 (Oregon).

The current practice location address for Shelly Rae Fox is 9615 Grand Ronde Rd, Grand Ronde, OR and can be reached out via phone at 503-879-2002.

Location: 9615 Grand Ronde Rd, Grand Ronde, OR, 97347-9712
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619664711
Provider Name
Shelly Rae Fox
Credential
Provider Entity Type
Individual
Gender
Female
Address
9615 Grand Ronde Rd, Grand Ronde, OR, 97347-9712
Phone Number
503-879-2002
Fax Number
Provider Enumeration Date
04/19/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9615 Grand Ronde Rd
City
Grand Ronde
State
Oregon
Zip
97347-9712
Phone Number
503-879-2002
Fax Number
person
Provider Business Mailing Address Details
Address
9615 Grand Ronde Rd
City
Grand Ronde
State
Oregon
Zip
97347-9712
Phone Number
503-879-2002
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000108778 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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