Provider Demographics
NPI:1003055922
Name:GUTIERREZ, ANA CECILIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:CECILIA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 W UNIVERSITY BLVD APT 17101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-3703
Mailing Address - Country:US
Mailing Address - Phone:972-904-7935
Mailing Address - Fax:972-838-1446
Practice Address - Street 1:6220 GASTON AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-4329
Practice Address - Country:US
Practice Address - Phone:972-904-7935
Practice Address - Fax:972-838-1446
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health