Provider Demographics
NPI:1750372926
Name:GUTIERREZ, MARGARITA C (MS, CCC, SLP)
Entity type:Individual
Prefix:MISS
First Name:MARGARITA
Middle Name:C
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 HAWKS NEST TER
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1126
Mailing Address - Country:US
Mailing Address - Phone:561-845-8898
Mailing Address - Fax:561-845-8898
Practice Address - Street 1:2555 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6250
Practice Address - Country:US
Practice Address - Phone:561-585-4881
Practice Address - Fax:561-585-7452
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 4288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist