Individual
ANTONIA GUTIERREZ BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
431 W 20TH ST, IDAHO FALLS, ID 83402-4423
(208) 316-8853
Mailing address
431 W 20TH ST, IDAHO FALLS, ID 83402-4423
(208) 316-8853
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-10649
ID
Other
Enumeration date
07/02/2024
Last updated
10/22/2025
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