MEDICARE: MS. JENNIFER D'ANN JIMENEZ LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	18071	TX

General Provider Information

NPI Number	:	1508988866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER D'ANN JIMENEZ LPC

Provider Business Mailing Address
First Line	:	8083 STONEBROOK PKWY
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-7203
Country	:	US
Telephone Number	:	214-886-6040
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 W AIRPORT FWY
Second Line	:	SUITE 430
City	:	IRVING
State	:	TX
Zip	:	75062-6312
Country	:	US
Telephone Number	:	214-886-6040
Fax Number	:	972-554-7102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2007
Last Update Date	:	01/30/2009

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