Healthcare Provider Details

I. General information

NPI: 1114588985
Provider Name (Legal Business Name): GABRIELA M GUTIERREZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 01/16/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 AVE. LUIS MUNOZ MARIN QUADRANGLE MEDICAL BUILDING
CAGUAS PR
00725
US

IV. Provider business mailing address

2T50 C 30 MIRADOR DE BAIROA
CAGUAS PR
00727-1002
US

V. Phone/Fax

Practice location:
  • Phone: 787-595-6085
  • Fax:
Mailing address:
  • Phone: 787-595-6085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6367
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: