Healthcare Provider Details

I. General information

NPI: 1629100763
Provider Name (Legal Business Name): DEBORAH LORENE GUTIERREZ BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 12/15/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 W PRINCETON CIR
DENVER CO
80236-3111
US

IV. Provider business mailing address

7523 S OGDEN WAY
CENTENNIAL CO
80122-3050
US

V. Phone/Fax

Practice location:
  • Phone: 720-734-5087
  • Fax: 303-734-5087
Mailing address:
  • Phone: 303-795-5442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACC.0997384
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0006443
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: