Provider Demographics
NPI:1568774081
Name:GUTIERREZ, DOLORES ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:ANN
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 DEVILS TOWER CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-2405
Mailing Address - Country:US
Mailing Address - Phone:915-780-8103
Mailing Address - Fax:
Practice Address - Street 1:8888 DYER ST
Practice Address - Street 2:SUITE 419
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-2867
Practice Address - Country:US
Practice Address - Phone:915-780-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional