| Stephanie Gutz, Inc. | |
|
1219 Gusdorf Rd Suite E Taos NM 87571-5402 | |
| (575) 779-3391 | |
| Not Available |
| Full Name | Stephanie Gutz, Inc. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 01/22/2014 |
| Last Update Date | 01/22/2014 |
| Medicare PECOS PAC ID | 3779707468 |
|---|---|
| Medicare Enrollment ID | O20140619002103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689097941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-06602 (New Mexico) | Primary |
| Provider Name | Stephanie Gutz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619909207 PECOS PAC ID: 3577599976 Enrollment ID: I20140619002192 |
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