Provider Demographics
NPI:1619502994
Name:DIX, CHRISTY (MA, CPC-I,)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:DIX
Suffix:
Gender:F
Credentials:MA, CPC-I,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7641 DESERT BREEZE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-5115
Mailing Address - Country:US
Mailing Address - Phone:702-882-5928
Mailing Address - Fax:
Practice Address - Street 1:7641 DESERT BREEZE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-5115
Practice Address - Country:US
Practice Address - Phone:702-882-5928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty