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General NPI Number Information
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NPI Number | 1073232005
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Entity Type | Individual
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Provider Name | KATHERINE GUTIERREZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 9250 CORKSCREW RD STE 12
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City | ESTERO
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State | FL
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Zip | 33928-3216
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Country | US
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Telephone | 239-601-4073
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 22ND ST W
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-5226
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Country | US
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Telephone | 239-601-4073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH21130
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License Number State | FL
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