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General NPI Number Information
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NPI Number | 1134578677
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Entity Type | Individual
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Provider Name | DR. RENEE GUTMAN
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Gender | Female
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 5715 N CALLE DE LUCIMIENTO
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City | TUCSON
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State | AZ
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Zip | 85718-5134
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Country | US
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Telephone | 520-299-1224
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Fax | 520-299-2208
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Provider Business Mailing Address
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Address Line | 5715 N CALLE DE LUCIMIENTO
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City | TUCSON
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State | AZ
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Zip | 85718-5134
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Country | US
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Telephone | 520-299-1224
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Fax | 520-299-2208
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3678
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 011178-1
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License Number State | NY
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