Provider Demographics
NPI:1558541920
Name:JIMENEZ, NANCY M (MA MHC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MA MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 DALEFORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-2305
Mailing Address - Country:US
Mailing Address - Phone:407-925-9744
Mailing Address - Fax:
Practice Address - Street 1:3707 DALEFORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-2305
Practice Address - Country:US
Practice Address - Phone:407-925-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist