Provider Demographics
NPI:1316970213
Name:NIX, ROBERT MANNING (MED)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MANNING
Last Name:NIX
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 CARRIAGE LN STE J
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6060
Mailing Address - Country:US
Mailing Address - Phone:843-452-6498
Mailing Address - Fax:843-573-5030
Practice Address - Street 1:1 CARRIAGE LN STE J
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6060
Practice Address - Country:US
Practice Address - Phone:843-452-6498
Practice Address - Fax:843-573-5030
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional