Individual
MS. ISABELLA EMMELIE RAIETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 BROCKMAN DR APT C, CHARLESTON, SC 29412-3783
(215) 206-8778
Mailing address
23 BROCKMAN DR APT C, CHARLESTON, SC 29412-3783
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
SC
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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