Provider Demographics
NPI:1184818940
Name:GUTIERREZ, JULIA M (LPC-S, CVE, CRC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LPC-S, CVE, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W DOVE AVE
Mailing Address - Street 2:# 66
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3576
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 W DOVE AVE
Practice Address - Street 2:# 66
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3576
Practice Address - Country:US
Practice Address - Phone:956-878-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63102101YM0800X
IL00048057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health