Provider Demographics
NPI:1962707109
Name:GUTIERREZ, NORA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NORA
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:P.O. BOX 610
Mailing Address - Street 2:
Mailing Address - City:PROGRESO
Mailing Address - State:TX
Mailing Address - Zip Code:78579
Mailing Address - Country:US
Mailing Address - Phone:956-565-3002
Mailing Address - Fax:956-260-0208
Practice Address - Street 1:600 N. BUSINESS 1015
Practice Address - Street 2:
Practice Address - City:PROGRESO
Practice Address - State:TX
Practice Address - Zip Code:78579
Practice Address - Country:US
Practice Address - Phone:956-565-3002
Practice Address - Fax:956-260-0208
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist