Healthcare Provider Details

I. General information

NPI: 1568850840
Provider Name (Legal Business Name): BELINDA GUTIERREZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TERRACE, 116B WILLIAM S. MIDDLETON MEMORIAL VETERANS HOSPITAL
MADISON WI
53705-2286
US

IV. Provider business mailing address

2500 OVERLOOK TERRACE, 116B WILLIAM S. MIDDLETON MEMORIAL VETERANS HOSPITAL
MADISON WI
53705
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: