Individual
JENIFER JIMISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1169 EASTERN PKWY STE 1236, LOUISVILLE, KY 40217-1462
(502) 829-7527
Mailing address
5322 HAVENTREE PL, LOUISVILLE, KY 40229-2263
(502) 829-7527
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
252367
KY
1041C0700X
Clinical Social Worker
Primary
256519
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100750990
—
KY
Enumeration date
07/06/2021
Last updated
07/24/2024
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