Individual
DIANE E GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1700 CERRILLOS ROAD, SANTA FE, NM 87505
(505) 946-9263
(505) 983-6243
Mailing address
02 SUNSET VIEW, SANTA FE, NM 87506
(505) 690-2190
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-3735
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N1949
—
NM
Enumeration date
10/03/2006
Last updated
07/08/2007
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