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1023775988
LISETTE PENA
MESA, AZ
NPI
1023775988
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
176B00000X Midwife
(Licence: AZ LM250)
Enumeration Date
2021-11-25
Last Update Date
2021-11-25
Business Address
LISETTE PENA LM, CPM
4121 E PUEBLO AVE
MESA, AZ 85206-5124
Phone number: 602-705-2307
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Mailing Address
LISETTE PENA LM, CPM
2113 S NIELSON ST
GILBERT, AZ 85295-5428
Phone number: 602-705-2307
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