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General NPI Number Information
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NPI Number | 1598195059
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Entity Type | Individual
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Provider Name | ANTOINETTE GUTIERREZ
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Gender | Female
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 724 N. BEN MADDOX WAY
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City | VISALIA
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State | CA
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Zip | 93274
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Country | US
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Telephone | 559-625-0331
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Fax |
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Provider Business Mailing Address
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Address Line | 1877 S IRWIN ST
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City | TULARE
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State | CA
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Zip | 93274-8425
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Country | US
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Telephone | 559-740-8426
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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 |
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License Number State |
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