Individual
AMANDA GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC-QS
Contact information
Practice address
92 SW 78TH PL, MIAMI, FL 33144-2335
(305) 458-9434
Mailing address
9539 MIDER DR, SAN ANTONIO, TX 78216-4352
(305) 458-9434
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MH15111
FL
101YM0800X
Mental Health Counselor
Primary
MH15111
FL
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/16/2012
Last updated
05/04/2023
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