Individual ProviderKathryn DietzwaySocial WorkerBehavioral Health & Social Service ProvidersPractice Address345 Doucet Rd Ste 217, Lafayette, LA 70503-3488(337) 202-5183(318) 787-7177PECOS EnrollmentBased on the most recent information from CMS, provider Kathryn Dietzway does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1821650987Provider TypeIndividualFull NameDietzway, KathrynCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date6/28/2019Last Updated7/2/2019Contact InformationPractice LocationPractice Address345 Doucet Rd Ste 217, Lafayette, LA 70503-3488Phone(337) 202-5183FaxUnlisted FaxMailing LocationMailing Address206 Corona Dr, Lafayette, LA 70503-4604Phone(318) 787-7177FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense13344Louisiana