Provider Demographics
NPI:1659713667
Name:SCOTT, CHRISTINE GUTIERREZ (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:GUTIERREZ
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:2611 LAUBACH RD
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0127
Mailing Address - Country:US
Mailing Address - Phone:210-591-8999
Mailing Address - Fax:
Practice Address - Street 1:2611 LAUBACH RD
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-0127
Practice Address - Country:US
Practice Address - Phone:210-591-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-13-13671103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst