Provider Demographics
NPI:1952651994
Name:DEBENETTI, ANALIA PAMELA
Entity Type:Individual
Prefix:MRS
First Name:ANALIA
Middle Name:PAMELA
Last Name:DEBENETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANALIA
Other - Middle Name:PAMELA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2658 230TH CT NW
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:MN
Mailing Address - Zip Code:55070-8739
Mailing Address - Country:US
Mailing Address - Phone:763-233-1816
Mailing Address - Fax:
Practice Address - Street 1:2658 230TH COURT NW
Practice Address - Street 2:
Practice Address - City:ST. FRANCIS
Practice Address - State:MN
Practice Address - Zip Code:55070
Practice Address - Country:US
Practice Address - Phone:763-233-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist