Provider Demographics
NPI:1861547358
Name:SENETTE, MARIA M (PT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:M
Last Name:SENETTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:T
Other - Last Name:MARINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:503 BREWSTER RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9587
Mailing Address - Country:US
Mailing Address - Phone:985-960-3717
Mailing Address - Fax:985-893-2654
Practice Address - Street 1:340 FALCONER DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8204
Practice Address - Country:US
Practice Address - Phone:985-893-2845
Practice Address - Fax:985-893-2654
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT 07097174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPT 07097OtherPT LICENSE