Most Relevant Information
Provider Data
| NPI Number: | 1003532821 |
| Provider Name: | MARIAH ANGELICA GUTIERREZ |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/13/2022 |
| Last Updated: | 10/13/2022 |
Provider Practice Location
536 LOS LENTES RD SE
LOS LUNAS
NM
870317052
Practice Location Phone/Fax
| Phone: | 5055141530 |
| Fax: |
Provider Mailing Location
72 JOURNEY RD
LOS LUNAS
NM
870318037
Provider Mailing Phone/Fax
| Phone: | 5055141530 |
| Fax: |