Individual
GEORGIA SUE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.S.C.S.W.
Contact information
Practice address
415 N POPLAR AVE, WICHITA, KS 67214-4529
(316) 686-6671
Mailing address
4103 N TARA CIR, WICHITA, KS 67226-3302
(316) 634-6480
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2396
KS
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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