Provider Demographics
NPI:1427212166
Name:FIX, DINA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DINA
Middle Name:
Last Name:FIX
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14090 FRYELAND BLVD SE
Mailing Address - Street 2:SUITE 347
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:360-805-3122
Mailing Address - Fax:360-805-9180
Practice Address - Street 1:14090 FRYELAND BLVD SE
Practice Address - Street 2:SUITE 347
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272
Practice Address - Country:US
Practice Address - Phone:360-805-3122
Practice Address - Fax:360-805-9180
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60453401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health