Individual
GAMALIEL JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4504 NW 46TH ST, WARR ACRES, OK 73122-5302
(787) 370-1973
Mailing address
4504 NW 46TH ST, WARR ACRES, OK 73122-5302
(787) 370-1973
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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