Individual
ANGEL JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
76 SUMMER ST, FITCHBURG, MA 01420-5783
(978) 343-2433
(978) 343-0791
Mailing address
76 SUMMER ST, FITCHBURG, MA 01420-5783
(978) 343-2433
(978) 343-0791
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306421
—
MA
05
—
1308785
—
MA
Enumeration date
07/09/2008
Last updated
07/09/2008
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