Individual
KIMBERLYN J OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
300 UNION ST, EVANSVILLE, WI 53536-1175
(608) 882-5613
Mailing address
300 UNION ST, EVANSVILLE, WI 53536-1175
(608) 882-5613
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3013
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39692500
—
WI
Enumeration date
01/22/2007
Last updated
01/18/2011
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