MEDICARE: MS. ALICIA L NIX BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1417276221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICIA L NIX BS

Provider Business Mailing Address
First Line	:	155 INVERNESS DR W
Second Line	:	SUITE 201
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-5095
Country	:	US
Telephone Number	:	720-210-7607
Fax Number	:

Provider Business Practice Location Address
First Line	:	1646 ELMIRA STREET
Second Line	:
City	:	AURORA
State	:	COLORADO
Zip	:	80010
Country	:	UM
Telephone Number	:	303-617-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2010
Last Update Date	:	05/19/2010

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