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NPI Code Detail

MEDICARE: ALEX GUTIERREZ

MEDICARE:   ALEX  GUTIERREZ
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 Analyst13773371-2506UT

General Provider Information

NPI Number : 1902267958
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX GUTIERREZ
Provider Business Mailing Address
First Line : 12222 S 1000 E STE 4
Second Line :
City : DRAPER
State : UT
Zip : 84020-3203
Country : US
Telephone Number : 801-987-3592
Fax Number :
Provider Business Practice Location Address
First Line : 12222 S 1000 E STE 4
Second Line :
City : DRAPER
State : UT
Zip : 84020-3203
Country : US
Telephone Number : 801-987-3592
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2016
Last Update Date : 05/22/2025

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Directions to “ ALEX GUTIERREZ ” Practice Location

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