Provider Demographics
NPI:1659559201
Name:KISER, CANDACE ELIZABETH (BA)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:ELIZABETH
Last Name:KISER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:STRINGTOWN
Mailing Address - State:OK
Mailing Address - Zip Code:74569-0220
Mailing Address - Country:US
Mailing Address - Phone:580-346-7301
Mailing Address - Fax:580-346-7214
Practice Address - Street 1:MACK ALFORD CORRECTIONAL CENTER
Practice Address - Street 2:
Practice Address - City:STRINGTOWN
Practice Address - State:OK
Practice Address - Zip Code:74569
Practice Address - Country:US
Practice Address - Phone:580-346-7301
Practice Address - Fax:580-346-7214
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)