Provider Demographics
NPI:1164863858
Name:GUTIERREZ, BARBARA D (EDD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:D
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6821 MIAMI LAKEWAY S
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2924
Mailing Address - Country:US
Mailing Address - Phone:305-812-6222
Mailing Address - Fax:
Practice Address - Street 1:6821 MIAMI LAKEWAY S
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2924
Practice Address - Country:US
Practice Address - Phone:305-812-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP27273235Z00000X
FLSA14310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist