Individual
JERONIMO JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
07336
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07236
THE MARYLAND STATE BOARD OF OCCUPATIONAL THERAPY PRACTICE
MD
Enumeration date
08/31/2015
Last updated
08/31/2015
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