MEDICARE: FRANCIA HELENA JIMENEZ SLP

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	235Z00000X	Speech-Language Pathologist	708410	GA

General Provider Information

NPI Number	:	1831549153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIA HELENA JIMENEZ SLP

Provider Business Mailing Address
First Line	:	4431 HOLIDAY HEIGHTS DR
Second Line	:
City	:	OAKWOOD
State	:	GA
Zip	:	30566-2404
Country	:	US
Telephone Number	:	770-633-1766
Fax Number	:

Provider Business Practice Location Address
First Line	:	4431 HOLIDAY HEIGHTS DR
Second Line	:
City	:	OAKWOOD
State	:	GA
Zip	:	30566-2404
Country	:	US
Telephone Number	:	770-633-1766
Fax Number	:

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

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	06/17/2016

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