Individual
KATHLEEN ELIZABETH GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-5110
Mailing address
8405 W CENTRAL AVE APT 607, WICHITA, KS 67212-3653
(404) 861-7431
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86149738
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
09/09/2022
Last updated
02/27/2024
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