Provider Demographics
NPI:1598023145
Name:FIX-FRY, ALICIA DOVE
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:DOVE
Last Name:FIX-FRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 HINANO ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4427
Mailing Address - Country:US
Mailing Address - Phone:808-969-1935
Mailing Address - Fax:808-969-3276
Practice Address - Street 1:622 HINANO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4427
Practice Address - Country:US
Practice Address - Phone:808-969-1935
Practice Address - Fax:808-969-3276
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator