Provider Demographics
NPI:1386822716
Name:GUTIERREZ, STEPHANIE FLINKO (SLP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FLINKO
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:FLINKO
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:1106 W QUAY AVE
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1826
Mailing Address - Country:US
Mailing Address - Phone:575-746-2777
Mailing Address - Fax:
Practice Address - Street 1:1106 W QUAY AVE
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1826
Practice Address - Country:US
Practice Address - Phone:575-746-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist