Basic Information
| Provider Information | |||||||||
| NPI: | 1710101464 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRAGONE-GUTIERREZ | ||||||||
| FirstName: | CATHANN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA LPC NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 MONROE ST NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871105821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5053071059 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2403 SAN MATEO BLVD NE | ||||||||
| Address2: | S-14 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871104058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058301871 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 03/24/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 0093771 | NM | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | 0093771 | NM | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 0093771 | NM | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YS0200X | 0093771 | NM | N | Behavioral Health & Social Service Providers | Counselor | School |
No ID Information.