Provider Demographics
NPI:1710468756
Name:GUTIERREZ, DUMAYI MARIA
Entity Type:Individual
Prefix:MRS
First Name:DUMAYI
Middle Name:MARIA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 REGENCY PARKWAY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3779
Mailing Address - Country:US
Mailing Address - Phone:402-932-2296
Mailing Address - Fax:402-281-0665
Practice Address - Street 1:444 REGENCY PARKWAY DR STE 104
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-932-2296
Practice Address - Fax:402-281-0665
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP12533106H00000X
NE11812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist