MEDICARE: MS. DUNIA GUTIERREZ ALFONSO

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
1	103K00000X	Behavioral Analyst		NV
2	163WH0200X	Home Health Registered Nurse	1031545	TX

General Provider Information

NPI Number	:	1568990935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DUNIA GUTIERREZ ALFONSO

Provider Business Mailing Address
First Line	:	5135 MORAVA LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-6478
Country	:	US
Telephone Number	:	702-401-0545
Fax Number	:

Provider Business Practice Location Address
First Line	:	3940 ALGONQUIN DR APT 139
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5308
Country	:	US
Telephone Number	:	702-883-9649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	07/21/2022

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