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Individual
STEPHANIE ASTUDILLO JIMENEZ
Active
Individual
STEPHANIE ASTUDILLO JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2019
Last updated
06/12/2023
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