Individual
ADAM A GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
401 S COLTRANE RD STE 206, EDMOND, OK 73034-6720
(580) 318-9415
Mailing address
605 N BROADWAY ST, TIPTON, OK 73570-9602
(580) 418-8246
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BCBA1174861
OK
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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