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General NPI Number Information
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NPI Number | 1477852192
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Entity Type | Organization
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Legal Business Name | ANTHONY A JIMENEZ PH.D. PLLC
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 1629 K ST NW
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City | WASHINGTON
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State | DC
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Zip | 20006-1602
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Country | US
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Telephone | 202-641-4725
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15657
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City | WASHINGTON
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State | DC
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Zip | 20003-0657
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Country | US
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Telephone | 202-641-4725
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ANTHONY ALFRED JIMENEZ
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Credential | PH.D.
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Telephone | 202-641-4725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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