Individual
JACQUELINE JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
111 PETROL PT, SUITE H, PEACHTREE CITY, GA 30269-1550
(312) 504-8523
Mailing address
515 WENTWORTH CT, FAYETTEVILLE, GA 30215-7833
(312) 504-8523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.010521
IL
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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