Provider Demographics
NPI:1205226479
Name:GAUTIER, MARIEL
Entity Type:Individual
Prefix:
First Name:MARIEL
Middle Name:
Last Name:GAUTIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L-3 CALLE RAFAEL CORTIJO
Mailing Address - Street 2:URB. ALTOS DE FLORIDA
Mailing Address - City:FLORIDA
Mailing Address - State:PR
Mailing Address - Zip Code:00650
Mailing Address - Country:US
Mailing Address - Phone:787-365-4375
Mailing Address - Fax:
Practice Address - Street 1:L-3 CALLE RAFAEL CORTIJO
Practice Address - Street 2:URB. ALTOS DE FLORIDA
Practice Address - City:FLORIDA
Practice Address - State:PR
Practice Address - Zip Code:00650
Practice Address - Country:US
Practice Address - Phone:787-365-4375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2018-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist