Individual
KASEY A NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2195 IRONWOOD CT STE D, COEUR D ALENE, ID 83814-2624
(208) 625-4887
Mailing address
3700 E OCEAN BLVD, APT 14, LONG BEACH, CA 90803-2749
(406) 202-3497
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6494
ID
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/19/2012
Last updated
04/08/2020
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