Individual
MARIALISA GUADALUPE GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 N PINE ST APT 4203, CANBY, OR 97013-3289
(503) 710-8096
Mailing address
800 N PINE ST APT 4203, CANBY, OR 97013-3289
(503) 710-8096
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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