Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | I.0009413-SUPV | OH |
NPI | 1003111840 |
---|---|
Provider Name | Mrs. Aminah C. T. Brahim-Jimenez |
First Address | Chagrin Falls, OH 44023-5486 |
Second Address | Pepper Pike, OH 44124-5712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2011 |
Last Update Date | 19/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0268768 | (05) | OH |