Provider Demographics
NPI:1023622990
Name:FOX, CHRISTOPHER J (BCBA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:FOX
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BELMONT RD
Mailing Address - Street 2:
Mailing Address - City:BELLMAWR
Mailing Address - State:NJ
Mailing Address - Zip Code:08031-1110
Mailing Address - Country:US
Mailing Address - Phone:609-680-7116
Mailing Address - Fax:
Practice Address - Street 1:1256 MARLKRESS RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2626
Practice Address - Country:US
Practice Address - Phone:856-888-1097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-20-44114103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14963089Medicaid