Provider Demographics
NPI:1376243709
Name:WALKER, JAMI LASH (IMH)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:LASH
Last Name:WALKER
Suffix:
Gender:F
Credentials:IMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-3914
Mailing Address - Country:US
Mailing Address - Phone:407-430-8888
Mailing Address - Fax:
Practice Address - Street 1:1939 BOOTHE CIR
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-6774
Practice Address - Country:US
Practice Address - Phone:407-285-6284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20073101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health