Individual
SANDRA M JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
617 SW MILL LN, LAKE CITY, FL 32024-0433
(386) 688-1025
Mailing address
617 SW MILL LN, LAKE CITY, FL 32024-0433
(386) 688-1025
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/16/2018
Last updated
09/25/2018
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