Provider Demographics
NPI:1235943234
Name:ISETTO, MARIA LORENA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LORENA
Last Name:ISETTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13315 WOOD CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6075
Mailing Address - Country:US
Mailing Address - Phone:314-852-7455
Mailing Address - Fax:
Practice Address - Street 1:13315 WOOD CHAPEL DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6075
Practice Address - Country:US
Practice Address - Phone:314-852-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter