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Individual

FONCEAL LOREN GUTIERREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
5109 RIVER RIDGE PL NW, ALBUQUERQUE, NM 87114-1232
(505) 899-9776
Mailing address
5109 RIVER RIDGE PL NW, ALBUQUERQUE, NM 87114-1232
(505) 899-9776

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5093
NM

Other

Enumeration date
01/17/2011
Last updated
08/27/2014
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