Healthcare Provider Details

I. General information

NPI: 1730282005
Provider Name (Legal Business Name): SHERRY L. GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA MEDICAL CENTER, AUDIOLOGY & SPEECH PATH (126) 50 IRVING ST. NW
WASHINGTON DC
20422
US

IV. Provider business mailing address

VA MEDICAL CENTER, AUDIOLOGY & SPEECH PATH (126) 50 IRVING ST. NW
WASHINGTON DC
20422
US

V. Phone/Fax

Practice location:
  • Phone: 410-381-3754
  • Fax:
Mailing address:
  • Phone: 202-745-8270
  • Fax: 202-745-8579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number00995
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: