Provider Demographics
NPI:1114588985
Name:GUTIERREZ, GABRIELA M (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:M
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 1:2T50 CALLE 30 MIRADOR DE BAIROA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1002
Mailing Address - Country:US
Mailing Address - Phone:787-595-6085
Mailing Address - Fax:
Practice Address - Street 1:D12 CALLE MIS AMORES
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5821
Practice Address - Country:US
Practice Address - Phone:787-930-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6367103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling