Provider Demographics
NPI:1548587314
Name:GUTIERREZ HERSH, ANNETTE M (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:M
Last Name:GUTIERREZ HERSH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8551 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4007
Mailing Address - Country:US
Mailing Address - Phone:305-788-7601
Mailing Address - Fax:
Practice Address - Street 1:8551 W SUNRISE BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4007
Practice Address - Country:US
Practice Address - Phone:305-788-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health