Reyna Doris Mae Jimenez
Social Worker, Clinical in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1417618471
StatusActive
Last updated in NPPESJun 10, 2024
Details
- NPI
- 1417618471
- Entity type
- Individual (NPI-1)
- Name
- Reyna Doris Mae Jimenez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 3, 2022
- Certification date
- Jun 10, 2024
- Last updated
- Jun 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | MI | Yes |
Practice location
300 68th St SeGrand Rapids, MI 49548-6927
Phone 616-456-6571
Mailing address
300 68th St SeGrand Rapids, MI 49548-6927
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