Individual
MISS OLIVIA NMN GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
101 W 18TH ST, BURLEY, ID 83318-2422
(661) 717-4811
Mailing address
101 W 18TH ST, BURLEY, ID 83318-2422
(661) 717-4811
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CADC-5071
ID
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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