Individual
ERIQUE EMMANUEL GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1096 MECHEM DR STE 213, RUIDOSO, NM 88345-7068
(575) 219-7542
Mailing address
1096 MECHEM DR STE 213, RUIDOSO, NM 88345-7068
(575) 219-7542
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-10317
NM
1041C0700X
Clinical Social Worker
Primary
C-11825
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82478058
—
NM
Enumeration date
08/16/2010
Last updated
07/20/2021
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