Individual
CHRISTINE MCCLARY JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3214 CLINTON AVE, FORT WORTH, TX 76106-5858
(817) 815-0700
Mailing address
1805 MAPLELEAF ST, FORT WORTH, TX 76111-1542
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
112770
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
659249401
—
TX
Enumeration date
05/31/2022
Last updated
05/31/2022
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