Provider Demographics
NPI:1750638110
Name:KIZER, BOBBI E (PHD)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:E
Last Name:KIZER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:E
Other - Last Name:KIZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4219 E PRAIRIE LANE CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6025
Mailing Address - Country:US
Mailing Address - Phone:504-390-5782
Mailing Address - Fax:
Practice Address - Street 1:4219 E PRAIRIE LANE CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223
Practice Address - Country:US
Practice Address - Phone:504-390-5782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-04
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling