Individual
DR. MARISA VICTORIA BYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
12443 SAN JOSE BLVD STE 202, JACKSONVILLE, FL 32223-8648
(904) 515-3503
Mailing address
11761 LANIER CREEK DR, JACKSONVILLE, FL 32258-1261
(904) 540-1216
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9588
FL
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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