Doctor Name: | MARIANA GUTIERREZ |
NPI Number: | 1326431123 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 67513 |
Business Practice Address: | 775 Indian Trl Ste 200 Harker Heights, TX - 765487026 |
Business Phone Number: | 8778005722 |
Business Fax Number: | |
Mailing Address: | 205 E University Ave Ste 200, GEORGETOWN |
State: | TX |
Postal Code: | 786266821 |
Phone Number: | 5126860207 |
Fax Number: | |
NPI Enumeration Date: | 03/18/2015 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 67513 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |