Individual
JAMES EDWIN GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1260 WILLOW TRL, BOSQUE FARMS, NM 87068-9054
(505) 379-7695
Mailing address
1260 WILLOW TRL, BOSQUE FARMS, NM 87068-9054
(505) 379-7695
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
851
NM
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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