Individual
JENNIFER JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 S MAIN ST, PAYETTE, ID 83661-2853
(208) 405-0020
Mailing address
818 SW 3RD AVE # 221-4349, PORTLAND, OR 97204-2405
(360) 780-3921
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
12/10/2024
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