Provider Demographics
NPI:1821406372
Name:GUTMANN, LILY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:
Last Name:GUTMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 DAHLONEGA RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2102
Mailing Address - Country:US
Mailing Address - Phone:301-996-0165
Mailing Address - Fax:
Practice Address - Street 1:4405 E WEST HWY STE 512
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4536
Practice Address - Country:US
Practice Address - Phone:301-996-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03051103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist