Individual
MARIAH DESTINI-RAE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529
(505) 766-5197
(505) 312-4046
Mailing address
5420 TERRITORIAL RD NW, ALBUQUERQUE, NM 87120-2941
(505) 319-4168
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NM
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
09/25/2025
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