Provider Demographics
NPI:1295597003
Name:GUTIERREZ, ANA P (BS)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:P
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N SOLANO DR APT 44
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1760
Mailing Address - Country:US
Mailing Address - Phone:575-222-6418
Mailing Address - Fax:
Practice Address - Street 1:755 S TELSHOR BLVD STE 201B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-3647
Practice Address - Country:US
Practice Address - Phone:575-222-6418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker