Individual
VANESSA M GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6519 4TH ST NW, LOS RANCHOS DE ALBUQUERQUE, NM 87107-5812
(505) 342-2500
(505) 342-2500
Mailing address
PO BOX 1563, BERNALILLO, NM 87004-1563
(505) 771-1434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1596
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23974559
—
NM
Enumeration date
11/09/2006
Last updated
07/08/2007
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