Individual
JODI LYNN NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
1904 W. ROYALE DR., MUNCIE, IN 47304-2664
(765) 284-0043
(765) 284-4112
Mailing address
1904 W. ROYALE DR., MUNCIE, IN 47304-2664
(765) 284-0043
(765) 284-4112
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20041828A
IN
103TH0100X
Health Service Psychologist
20041828A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200295010
—
IN
01
—
P01299489
MEDICARE RAILROAD
IN
Enumeration date
06/22/2005
Last updated
11/27/2023
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