Individual
STEVEN L. WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
482 JACKSONVILLE DR, JACKSONVILLE BEACH, FL 32250-3812
(904) 247-3600
Mailing address
134 GLEN COVE PL, PONTE VEDRA BEACH, FL 32082-3637
(904) 994-0997
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4575
FL
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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