Provider Demographics
NPI:1336764216
Name:NIX, KASHA DAVETTE (ADC)
Entity Type:Individual
Prefix:MRS
First Name:KASHA
Middle Name:DAVETTE
Last Name:NIX
Suffix:
Gender:F
Credentials:ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E CHOCCOLOCCO ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-1222
Mailing Address - Country:US
Mailing Address - Phone:256-831-4601
Mailing Address - Fax:
Practice Address - Street 1:118 E CHOCCOLOCCO ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-1222
Practice Address - Country:US
Practice Address - Phone:256-831-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)