Provider Demographics
NPI:1609214006
Name:LANDEN, JAMI LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMI
Middle Name:LYNN
Last Name:LANDEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19300 W DIXIE HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2201
Mailing Address - Country:US
Mailing Address - Phone:954-614-7731
Mailing Address - Fax:
Practice Address - Street 1:19300 W DIXIE HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2201
Practice Address - Country:US
Practice Address - Phone:954-614-7731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6836103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent