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Individual

KRISTIN DANIELLE JIMENEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAS-LAMFT

Contact information

Practice address
4635 S LAKESHORE DR STE 102, TEMPE, AZ 85282-7127
(480) 243-9343
Mailing address
4635 S LAKESHORE DR STE 102, TEMPE, AZ 85282-7127
(480) 243-9343

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LAMFT-10543
101Y00000X
Counselor
Primary
LMFT-15620
AZ
101YM0800X
Mental Health Counselor
LMFT-15620
AZ

Other

Enumeration date
10/02/2019
Last updated
05/04/2023
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