| Doctor Name: | MADELINE JIMENEZ |
| NPI Number: | 1083814842 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | 2257 |
| Business Practice Address: | Cond San Ignacio Apto. 1405a Rio Piedras, PR - 009213814 |
| Business Phone Number: | 7872221053 |
| Business Fax Number: | 7877639693 |
| Mailing Address: | Cond San Ignacio, Apto. 1405a RIO PIEDRAS |
| State: | PR |
| Postal Code: | 009213814 |
| Phone Number: | 7872221053 |
| Fax Number: | 7877639693 |
| NPI Enumeration Date: | 07/20/2007 |
| NPI Last Update Date: | 07/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2257 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |