Provider Demographics
NPI:1366756454
Name:FOXAN, KATHEE JOLIENE (LISW)
Entity type:Individual
Prefix:
First Name:KATHEE
Middle Name:JOLIENE
Last Name:FOXAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-2726
Mailing Address - Country:US
Mailing Address - Phone:563-659-7815
Mailing Address - Fax:563-659-7815
Practice Address - Street 1:111 S VERMONT ST
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060-2726
Practice Address - Country:US
Practice Address - Phone:563-659-7815
Practice Address - Fax:563-659-7815
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0075241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical