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Individual

MR. JAY LOUIS CIMMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
30 W INDIANA AVE, BLOOMFIELD, IN 47424-1200
(812) 384-3946
(812) 384-3948
Mailing address
4337 E BILL MALLORY BLVD, BLOOMINGTON, IN 47401-8635
(812) 322-3680

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
35001529A
IN
106H00000X
Marriage & Family Therapist
Primary
35001529A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000330621
ANTHEM
Enumeration date
12/01/2005
Last updated
08/21/2007
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