Stephanie Gutz, Inc. | |
1219 Gusdorf Rd Suite E Taos NM 87571-5402 | |
(575) 779-3391 | |
Not Available |
Full Name | Stephanie Gutz, Inc. |
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Speciality | Social Worker |
Location | 1219 Gusdorf Rd, Taos, New Mexico |
Authorized Official Name and Position | Stephanie Gutz (PRESIDENT) |
Authorized Official Contact | 5757793391 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stephanie Gutz, Inc. Po Box 1077 El Prado NM 87529-1077 Ph: (575) 779-3391 | Stephanie Gutz, Inc. 1219 Gusdorf Rd Suite E Taos NM 87571-5402 Ph: (575) 779-3391 |
NPI Number | 1689097941 |
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Provider Enumeration Date | 01/22/2014 |
Last Update Date | 01/22/2014 |
Medicare PECOS PAC ID | 3779707468 |
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Medicare Enrollment ID | O20140619002103 |
Identifier | Type | State | Issuer |
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1689097941 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | I-06602 (New Mexico) | Primary |
Provider Name | Stephanie Gutz |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1619909207 PECOS PAC ID: 3577599976 Enrollment ID: I20140619002192 |
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