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NPI Code Detail

MEDICARE: LAURA GUTIERREZ MA

MEDICARE: LAURA GUTIERREZ MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyNLC.0106508CO

General Provider Information

NPI Number : 1093247884
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA GUTIERREZ MA
Provider Business Mailing Address
First Line : 10275 DOWDLE DR
Second Line :
City : GOLDEN
State : CO
Zip : 80403-8615
Country : US
Telephone Number : 954-701-8320
Fax Number :
Provider Business Practice Location Address
First Line : 211 S 21ST AVE
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2581
Country : US
Telephone Number : 303-655-9065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2017
Last Update Date : 03/30/2017

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Directions to “ LAURA GUTIERREZ MA” Practice Location

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