Provider Demographics
NPI:1629100763
Name:GUTIERREZ, DEBORAH LORENE (BA)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LORENE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7523 S OGDEN WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3050
Mailing Address - Country:US
Mailing Address - Phone:303-795-5442
Mailing Address - Fax:
Practice Address - Street 1:3844 W PRINCETON CIR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-3111
Practice Address - Country:US
Practice Address - Phone:720-734-5087
Practice Address - Fax:303-734-5087
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0997384101YA0400X
COLPC.0006443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)