Provider Demographics
NPI:1679685531
Name:GUTIERREZ, YVETTE (PSY D)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S 1ST ST
Mailing Address - Street 2:CTVHCS , SATP BUILDING 146
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-7451
Mailing Address - Country:US
Mailing Address - Phone:254-743-1855
Mailing Address - Fax:254-743-0495
Practice Address - Street 1:1901 S 1ST ST
Practice Address - Street 2:CTVHCS , SATP BUILDING 146
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-743-1855
Practice Address - Fax:254-743-0495
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNONE103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical