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NPI Code Detail

MEDICARE: CRISTINA M GUTIERREZ LSW

MEDICARE: CRISTINA M GUTIERREZ LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerS.1601091OH

General Provider Information

NPI Number : 1962921122
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTINA M GUTIERREZ LSW
Provider Business Mailing Address
First Line : 5164 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43623-3471
Country : US
Telephone Number : 419-720-9586
Fax Number :
Provider Business Practice Location Address
First Line : 5164 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43623-3471
Country : US
Telephone Number : 419-720-9586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2017
Last Update Date : 07/21/2022

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Directions to “ CRISTINA M GUTIERREZ LSW” Practice Location

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