Landen, Carol

Landen, Carol is an individual health care provider with primary practice located at 260 S Marion Ave Bldg A, Suite 135, Lake City FL 32025-7000. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Landen, Carol can be contacted via phone (352) 373-4411.

Contact Information

Primary practice address
260 S Marion Ave Bldg A, Suite 135 Lake City FL 32025-7000
Phone: (352) 373-4411
Fax: (352) 373-4455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1164969465
LBN Legal business name Landen, Carol
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2017
Last updated Jul 6th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164969465 NPPES
Florida MEDICAID 19833300

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