Provider Demographics
NPI:1932143864
Name:OTTO, FRANCES JEAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:JEAN
Last Name:OTTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:FRANCES
Other - Middle Name:JEAN
Other - Last Name:OTTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:1704 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1234
Mailing Address - Country:US
Mailing Address - Phone:814-455-7405
Mailing Address - Fax:814-455-7405
Practice Address - Street 1:1704 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1234
Practice Address - Country:US
Practice Address - Phone:814-455-7405
Practice Address - Fax:814-455-7405
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008882L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0852210Medicare ID - Type Unspecified