Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6367 | PR |
NPI | 1114588985 |
---|---|
Provider Name | Mrs. Gabriela M Gutierrez |
First Address | Caguas, PR 00727-1002 |
Second Address | Caguas, PR 00725-5821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2019 |
Last Update Date | 24/06/2019 |