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NPI Code Detail

MEDICARE: MR. MICHAEL GUTIERREZ BCBA

MEDICARE: MR. MICHAEL GUTIERREZ BCBA
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
1103K00000XBehavior Analyst1-13-14451NM

General Provider Information

NPI Number : 1851712574
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL GUTIERREZ BCBA
Provider Business Mailing Address
First Line : 301 PERKINS DR STE B
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3248
Country : US
Telephone Number : 575-652-3155
Fax Number :
Provider Business Practice Location Address
First Line : 1675 HICKORY LOOP
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-6587
Country : US
Telephone Number : 575-652-3155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2013
Last Update Date : 03/17/2026

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