Provider Demographics
NPI:1073985297
Name:JIMENEZ, MARIA L (MS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LAURELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01537-4642
Mailing Address - Country:US
Mailing Address - Phone:508-502-8787
Mailing Address - Fax:
Practice Address - Street 1:2 LAURELWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01537-4642
Practice Address - Country:US
Practice Address - Phone:508-502-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health