| NPI | 1174773469 |
|---|---|
| Former Name | AMANDA JIMENEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 4753) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 4753) |
| 104100000X Social Worker (Licence: TX 50864) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2022-10-31 |