Healthcare Provider Details

I. General information

NPI: 1104912716
Provider Name (Legal Business Name): FRANCIS KAY ALLTIZER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FRANCIS KAY ALLTIZER-JOINER LCSW

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 MOW WAY ROAD
FT. SILL OK
73503
US

IV. Provider business mailing address

4714 NW MOTIF MANOR BLVD APT. B
LAWTON OK
73505
US

V. Phone/Fax

Practice location:
  • Phone: 580-458-3600
  • Fax:
Mailing address:
  • Phone: 580-284-4775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2401
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: