Evalyn Yvette Otzenberger | Lafayette, LA • PECOS Search

Evalyn Yvette Otzenberger

Social Worker

Behavioral Health & Social Service Providers

105 Woodbine Dr, Lafayette, LA 70503-6216

PECOS Enrollment

Based on the most recent information from CMS, provider Evalyn Yvette Otzenberger does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 10:46 AM.

Profile Details

Provider ID
1033402938
Provider Type
Individual
Full Name
Otzenberger, Evalyn Yvette
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/25/2011
Last Updated
5/25/2011

Contact Information

Practice Location

105 Woodbine Dr, Lafayette, LA 70503-6216

Unlisted Fax

Mailing Location

105 Woodbine Dr, Lafayette, LA 70503-6216

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 2829 Louisiana