Provider Demographics
NPI:1891142790
Name:GUTIERREZ, ASHLEY (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
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 1:9112 NOLLEY CT UNIT F
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-3407
Mailing Address - Country:US
Mailing Address - Phone:910-398-5801
Mailing Address - Fax:
Practice Address - Street 1:6041 PIEDMONT ROW DR S
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-4967
Practice Address - Country:US
Practice Address - Phone:980-443-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist