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Contact Information

ROXANNE PRUITT KISER, LCSW, LICSW
4060 602ND ST
BACH
FORT WAINWRIGHT, AK99703
 Phone: 073-617-2039
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for ROXANNE PRUITT KISER · (Female)

NPI # 1548743321
Status Active
Credentials LCSW, LICSW
Entity Individual
Enumeration date 09/08/2018
Last updated 09/20/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NC License # C011676
  • MN Other 32055 LICSW
  • NC Other C011676 LCSW
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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