How does Carmela see Isabella?

I'll try to keep this simple: it's clear that Isabella is a hallucination of Tony Soprano. But when Tony is looking out of his window and caught by Carmela, she looks outside and asks "Who is she?" and they argue, despite the neighborly doctor later refuting that any Italian exchange student was at his home while away.

So, how does Carmela see what is made clear to the audience, a hallucination? She is the only one other than Tony who appears to recognize her.
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