Individual
KAYLEIGH C GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSW
Contact information
Practice address
807 CALLE CHAMISAL, ESPANOLA, NM 87532-2976
(150) 569-2729
Mailing address
807 CALLE CHAMISAL, ESPANOLA, NM 87532-2976
(150) 569-2729
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1576
NM
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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