Nix, Traci D

Nix, Traci D is an sole proprietor health care provider with primary practice located at 194 Fountain St , New Haven CT 06515. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Nix, Traci D can be contacted via phone (206) 579-2305.

Contact Information

Primary practice address
194 Fountain St New Haven CT 06515
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041928A Indiana

Profile Details

NPI number 1710959101
LBN Legal business name Nix, Traci D
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2006
Last updated Apr 28th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710959101 NPPES
Indiana MEDICAID 200473540A

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