Individual
MRS. LACEY J GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., RBT, ITFS
Contact information
Practice address
3415 MELROSE RD STE C1, FAYETTEVILLE, NC 28304-1634
(910) 425-6282
Mailing address
3415 MELROSE RD STE C1, FAYETTEVILLE, NC 28304-1634
(910) 425-6282
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-15-06056
NC
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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