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Individual
SHIRLEY NADINE JIMENEZ
Active
Individual
SHIRLEY NADINE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
117025
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117025
LICENSE REGISTRATION
NY
01
—
494023663
DRIVER LICENSE
NY
Enumeration date
12/06/2022
Last updated
12/06/2022
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