Provider Demographics
NPI:1043466675
Name:GUTIERREZ, NATALIE KAY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:KAY
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 MAGGIE LN
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-3160
Mailing Address - Country:US
Mailing Address - Phone:706-302-3395
Mailing Address - Fax:
Practice Address - Street 1:6065 MAGGIE LN
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-3160
Practice Address - Country:US
Practice Address - Phone:706-302-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6584103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical