Provider Demographics
NPI:1396172508
Name:GUERRA DE GUTIERREZ, ESPERANZA (LCSW)
Entity type:Individual
Prefix:
First Name:ESPERANZA
Middle Name:
Last Name:GUERRA DE GUTIERREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N LEE TREVINO DR STE C4
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-5164
Mailing Address - Country:US
Mailing Address - Phone:915-542-0300
Mailing Address - Fax:915-591-4054
Practice Address - Street 1:1600 N LEE TREVINO DR STE C4
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5164
Practice Address - Country:US
Practice Address - Phone:915-542-0300
Practice Address - Fax:915-591-4054
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08035104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker