Provider Demographics
NPI:1972923696
Name:GUTIERREZ-RUIZ, ZOAN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ZOAN
Middle Name:
Last Name:GUTIERREZ-RUIZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CALLE BRISAIDA
Mailing Address - Street 2:URB. MUNOZ RIVERA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3529
Mailing Address - Country:US
Mailing Address - Phone:787-688-2294
Mailing Address - Fax:
Practice Address - Street 1:32 CALLE BRISAIDA
Practice Address - Street 2:URB. MUNOZ RIVERA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3529
Practice Address - Country:US
Practice Address - Phone:787-688-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist