Most Relevant Information
Provider Data
| NPI Number: | 1003635442 |
| Provider Name: | RAVEN JIMENEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/03/2024 |
| Last Updated: | 10/03/2024 |
Provider Practice Location
10815 JAMAICA AVE
RICHMOND HILL
NY
114182243
Practice Location Phone/Fax
| Phone: | 9178647116 |
| Fax: |
Provider Mailing Location
10815 JAMAICA AVE
RICHMOND HILL
NY
114182243
Provider Mailing Phone/Fax
| Phone: | 9178647116 |
| Fax: |