Doctor Name: | MRS. OLGA LIDIA JIMENEZ |
NPI Number: | 1528080611 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 2202003713 |
Business Practice Address: | 3750 Old Lee Hwy Fairfax, VA - 220301806 |
Business Phone Number: | 7032465314 |
Business Fax Number: | |
Mailing Address: | 3002 White Birch Ct, FAIRFAX |
State: | VA |
Postal Code: | 220311122 |
Phone Number: | 7032469489 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202003713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |