Individual
KORTNEI DIANE GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3838 NW 36TH ST STE 200, OKLAHOMA CITY, OK 73112-2916
(405) 702-9032
(405) 702-9031
Mailing address
1205 KINGSTON BLVD, EDMOND, OK 73034-3227
(580) 318-9415
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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