Individual
MS. IRIS V GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
(859) 254-7874
Mailing address
20 MEDICAL VILLAGE DR, SUITE 107, EDGEWOOD, KY 41017-5401
(859) 341-5014
(859) 341-5136
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3769
KY
171M00000X
Case Manager/Care Coordinator
5078
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100274070
—
KY
Enumeration date
01/09/2007
Last updated
03/17/2018
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