Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 15005 | TX |
NPI | 1003055922 |
---|---|
Provider Name | Ms. Ana Cecilia Gutierrez |
First Address | Dallas, TX 75209-3703 |
Second Address | Dallas, TX 75214-4329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2009 |
Last Update Date | 17/02/2009 |