| Doctor Name: | MARLISSA SUZANNE DIX |
| NPI Number: | 1063602886 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | C2340 |
| Business Practice Address: | 58646 Mcnulty Way Saint Helens, OR - 970516210 |
| Business Phone Number: | 5033975211 |
| Business Fax Number: | 5033975373 |
| Mailing Address: | Po Box 1234, SAINT HELENS |
| State: | OR |
| Postal Code: | 970518234 |
| Phone Number: | 5033975211 |
| Fax Number: | 5033975373 |
| NPI Enumeration Date: | 07/27/2007 |
| NPI Last Update Date: | 07/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C2340 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |