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Individual
ODELTA GUTIERREZ CLONTZ
Active
Individual
ODELTA GUTIERREZ CLONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9707
NC
101YP2500X
Professional Counselor
66026
TX
101YP2500X
Professional Counselor
9707
NC
103T00000X
Psychologist
1793
PR
Other
Enumeration date
10/19/2006
Last updated
05/11/2020
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