Provider Demographics
NPI:1932617412
Name:BOBBI KIZER PHD LLC
Entity type:Organization
Organization Name:BOBBI KIZER PHD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:KIZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-390-5782
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:99223-6025
Practice Address - Country:US
Practice Address - Phone:504-390-5782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60804591103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty