Individual
MARK JIMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
954 AVE PONCE DE LEON STE 405C, SAN JUAN, PR 00907
(413) 636-5691
Mailing address
PO BOX 79872, CAROLINA, PR 00984-9872
(413) 636-5691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1030600
MA
Other
Enumeration date
02/01/2007
Last updated
08/13/2018
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