Provider Demographics
NPI:1770898389
Name:GUTIERREZ, PEDRO (MED, CTS, LPC)
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:MED, CTS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 HACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2730
Mailing Address - Country:US
Mailing Address - Phone:956-455-5735
Mailing Address - Fax:
Practice Address - Street 1:2736 HACKBERRY LN
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2730
Practice Address - Country:US
Practice Address - Phone:956-455-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64474101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor