Provider Demographics
NPI:1235223421
Name:GUTIERREZ WRAY, KATHERINE BETTY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:BETTY
Last Name:GUTIERREZ WRAY
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 1:19 LONGFELLOW DR
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2309
Mailing Address - Country:US
Mailing Address - Phone:413-262-0297
Mailing Address - Fax:
Practice Address - Street 1:235 MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5123
Practice Address - Country:US
Practice Address - Phone:413-532-0389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health