Individual
ANGELIQUE C GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
123 DUPONT DR NW, AIKEN, SC 29801-4089
(803) 648-0434
Mailing address
1520 S ESPERANZA ST, LAS CRUCES, NM 88001-4244
(575) 418-7582
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
120131
TX
225X00000X
Occupational Therapist
2018010808
MO
225X00000X
Occupational Therapist
Primary
5586
SC
225X00000X
Occupational Therapist
OT20143
FL
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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