Provider Demographics
NPI:1750882999
Name:GUTIERREZ, JASMINE
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:
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 1:3250 70TH ST APT 2G
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1712
Mailing Address - Country:US
Mailing Address - Phone:347-668-7159
Mailing Address - Fax:
Practice Address - Street 1:3250 70TH ST APT 2G
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1712
Practice Address - Country:US
Practice Address - Phone:347-668-7159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor