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Individual

PATRICIA MARIE JIMENEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC-R

Contact information

Practice address
102 S 2ND AVE STE E, MAYODAN, NC 27027-2712
(336) 389-8739
Mailing address
401 N 11TH AVE, MAYODAN, NC 27027-2113
(336) 389-8739

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
171M00000X
Case Manager/Care Coordinator
NC

Other

Enumeration date
08/22/2022
Last updated
07/03/2025
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