Individual
DAMARIS GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS & RBT
Contact information
Practice address
8491 NW 17TH ST STE 110, DORAL, FL 33126-1025
(305) 456-5542
(786) 598-7590
Mailing address
3250 W 9TH AVE, HIALEAH, FL 33012-5010
(305) 794-3390
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-89497
FL
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105159600
—
FL
Enumeration date
03/11/2022
Last updated
02/16/2024
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