Provider Demographics
NPI:1184097263
Name:VIX, MISTY
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:VIX
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 1:2626 CANAL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6400
Mailing Address - Country:US
Mailing Address - Phone:504-525-2366
Mailing Address - Fax:
Practice Address - Street 1:2626 CANAL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6400
Practice Address - Country:US
Practice Address - Phone:504-525-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional