Individual
MS. CARMEN J JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10501 34TH AVENUE, CORONA, NY 11368-1109
(718) 458-7818
(718) 458-7818
Mailing address
10501 34TH AVENUE, CORONA, NY 11368-1109
(718) 458-7818
(718) 458-7818
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
R0367271
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02265341
—
NY
Enumeration date
01/05/2007
Last updated
11/12/2022
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