NPI | 1033291091 |
---|---|
Former Name | ODELTA M GUTIERREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 9707) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 9707) |
101YP2500X Counselor, Professional (Licence: TX 66026) | |
103T00000X Psychologist (Licence: PR 1793) | |
Enumeration Date | 2006-10-19 |
Last Update Date | 2020-05-11 |