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General NPI Number Information
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NPI Number | 1346052594
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Entity Type | Individual
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Provider Name | KAREN MARIE GUTIERREZ CONCEPCION PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | BO. CAIMITAL ALTO CARR #2 KM 121.8 INT
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 787-460-2096
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64
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City | SAN ANTONIO
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State | PR
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Zip | 00690-0064
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Country | US
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Telephone | 787-460-2096
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 8163
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License Number State | PR
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