Provider Demographics
NPI:1710639810
Name:KIZER, RUTH JEANNETTE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:JEANNETTE
Last Name:KIZER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 ROSEDALE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2026
Mailing Address - Country:US
Mailing Address - Phone:940-782-1635
Mailing Address - Fax:
Practice Address - Street 1:6606 ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2026
Practice Address - Country:US
Practice Address - Phone:940-782-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional