Provider Demographics
NPI:1750824454
Name:GUTIERREZ, BRIANA NICOLE
Entity Type:Individual
Prefix:MS
First Name:BRIANA
Middle Name:NICOLE
Last Name:GUTIERREZ
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 1:1405 N DOBSON RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-8594
Mailing Address - Country:US
Mailing Address - Phone:480-722-1300
Mailing Address - Fax:480-422-3824
Practice Address - Street 1:1405 N DOBSON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-8594
Practice Address - Country:US
Practice Address - Phone:480-722-1300
Practice Address - Fax:480-422-3824
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA103432355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant