Provider Demographics
NPI:1619121761
Name:GUTIERREZ, PATRICIA KUNITZKY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:KUNITZKY
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:KUNITZKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1200 DELTONA BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-6306
Mailing Address - Country:US
Mailing Address - Phone:386-575-5022
Mailing Address - Fax:
Practice Address - Street 1:1200 DELTONA BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-6306
Practice Address - Country:US
Practice Address - Phone:386-557-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health