Provider Demographics
NPI:1982299277
Name:PINTO, IRIS
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:PINTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14188 MOTHER TERESA LN
Mailing Address - Street 2:
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-7554
Mailing Address - Country:US
Mailing Address - Phone:531-355-3025
Mailing Address - Fax:531-355-7150
Practice Address - Street 1:14188 MOTHER TERESA LN
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7554
Practice Address - Country:US
Practice Address - Phone:531-355-3025
Practice Address - Fax:531-355-7150
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12438101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor