Individual
MRS. KACI LYNN JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19362 W WOODLANDS AVE, BUCKEYE, AZ 85326-5831
(623) 980-5232
Mailing address
19362 W WOODLANDS AVE, BUCKEYE, AZ 85326-5831
(623) 980-5232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-008522
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/16/2020
Last updated
01/12/2026
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