Individual
KATHRYN DIETZWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
345 DOUCET RD STE 217, LAFAYETTE, LA 70503-3488
(337) 202-5183
Mailing address
206 CORONA DR, LAFAYETTE, LA 70503-4604
(318) 787-7177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13344
LA
Other
Enumeration date
06/28/2019
Last updated
07/02/2019
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