Provider Demographics
NPI:1053577791
Name:KUNTZ-BUTLER, ALYSON (CPM, LM)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:KUNTZ-BUTLER
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 E MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5615
Mailing Address - Country:US
Mailing Address - Phone:915-525-5183
Mailing Address - Fax:915-533-2187
Practice Address - Street 1:1511 E MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5615
Practice Address - Country:US
Practice Address - Phone:915-525-5183
Practice Address - Fax:915-533-2187
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96108176B00000X
NM96393R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife