Individual
DR. TRACI D NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
194 FOUNTAIN ST, NEW HAVEN, CT 06515
(206) 579-2305
Mailing address
194 FOUNTAIN ST, NEW HAVEN, CT 06515-1902
(206) 579-2305
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
20041928A
IN
103TC0700X
Clinical Psychologist
Primary
38305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200473540A
—
IN
Enumeration date
02/01/2006
Last updated
10/24/2024
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