Gutierrez, Patricia Rose

Gutierrez, Patricia Rose is an sole proprietor health care provider with primary practice located at 147 Randall St , Waukesha WI 53188-3528. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Gutierrez, Patricia Rose can be contacted via phone (262) 510-8490.

Contact Information

Primary practice address
147 Randall St Waukesha WI 53188-3528
Phone: (262) 510-8490
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 7295-125 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11046-132 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11046 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Professional 101YP2500X 7295-125
Behavioral Health & Social Service Providers / Professional 101YP2500X Wisconsin

Profile Details

NPI number 1952577488
LBN Legal business name Gutierrez, Patricia Rose
Credentials CSAC, ICS, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2008
Last updated Oct 14th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952577488 NPPES
Wisconsin MEDICAID 39384900
Wisconsin MEDICAID 1952577488

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