| NPI | 1578017091 |
|---|---|
| Former Name | EVELYN ELIZABETH JIMENEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC8652) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC PRC15202) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2024-08-20 |