Provider Demographics
NPI:1215680863
Name:GUERRERO-GAY, KIERA LEXI
Entity type:Individual
Prefix:
First Name:KIERA
Middle Name:LEXI
Last Name:GUERRERO-GAY
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 1:1126 PORT ROYAL RD
Mailing Address - Street 2:
Mailing Address - City:PINGREE GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-9196
Mailing Address - Country:US
Mailing Address - Phone:847-345-9619
Mailing Address - Fax:
Practice Address - Street 1:1126 PORT ROYAL RD
Practice Address - Street 2:
Practice Address - City:PINGREE GROVE
Practice Address - State:IL
Practice Address - Zip Code:60140-9196
Practice Address - Country:US
Practice Address - Phone:847-345-9619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer