Provider Demographics
NPI:1043272560
Name:GUTIERREZ, ANNE C (MS, ATC, CSCS)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:C
Last Name:GUTIERREZ
Suffix:
Gender:
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12433 MAYS QUARTER RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5478
Mailing Address - Country:US
Mailing Address - Phone:806-549-8467
Mailing Address - Fax:
Practice Address - Street 1:2189 ELROD AVE
Practice Address - Street 2:
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134-5113
Practice Address - Country:US
Practice Address - Phone:703-432-6536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260038682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer