Provider Demographics
NPI:1780771303
Name:OETTING, LISA (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:OETTING
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 S EASTERN AVE
Mailing Address - Street 2:APT 426
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2989
Mailing Address - Country:US
Mailing Address - Phone:702-932-2290
Mailing Address - Fax:702-932-2299
Practice Address - Street 1:2011 PINTO LN
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4018
Practice Address - Country:US
Practice Address - Phone:702-382-3200
Practice Address - Fax:702-932-2299
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS