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NPI Code Detail

MEDICARE: ALICE A GUTIERREZ SOTO

MEDICARE: ALICE A GUTIERREZ SOTO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1487510731
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE A GUTIERREZ SOTO
Provider Business Mailing Address
First Line : 1633 S 171ST ST
Second Line :
City : NEW BERLIN
State : WI
Zip : 53151-1337
Country : US
Telephone Number : 262-745-6674
Fax Number :
Provider Business Practice Location Address
First Line : 200 N PATRICK BLVD UNIT 250
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-5883
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2025
Last Update Date : 12/30/2025

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Directions to “ ALICE A GUTIERREZ SOTO ” Practice Location

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