Most Relevant Information
Provider Data
| NPI Number: | 1003052572 |
| Provider Name: | JESSICA MARIE GUTIERREZ LCSW, CSAC, ICS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 15584-132 |
Most Important Dates
| Enumeration Date: | 01/05/2009 |
| Last Updated: | 08/13/2024 |
Provider Practice Location
2101 LINDEN AVE APT 2
MADISON
WI
537045350
Practice Location Phone/Fax
| Phone: | 6084666560 |
| Fax: |
Provider Mailing Location
2101 LINDEN AVE APT 2
MADISON
WI
537045350
Provider Mailing Phone/Fax
| Phone: | 6084666560 |
| Fax: |