Individual
ETHEL M NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
425 PLEASANT STREET, BROCKTON, MA 02301
(508) 584-5400
(508) 584-5402
Mailing address
247 CALLENDER ST, DORCHESTER, MA 02124-2822
(617) 953-6640
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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