Individual
SAMANTHA ALIX GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
49 EL CERRO LOOP, LOS LUNAS, NM 87031-7261
(505) 261-4779
Mailing address
49 EL CERRO LOOP, LOS LUNAS, NM 87031-7261
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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