Individual
LUZ MILAGRO GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
258 ACUSHNET AVE, NEW BEDFORD, MA 02740-4904
(774) 478-1896
Mailing address
258 ACUSHNET AVE, NEW BEDFORD, MA 02740-4904
(774) 478-1896
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100041802669
MASS HEALTH
MA
Enumeration date
04/28/2022
Last updated
04/28/2022
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