Individual
DR. ALICIA ELISA AYALA LACONICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D IN PSYCHOLOGY
Contact information
Practice address
12574 FLAGLER CENTER BLVD, STE 101, JACKSONVILLE, FL 32258-2615
(904) 374-4276
(888) 495-1508
Mailing address
12574 FLAGLER CENTER BLVD STE 101, JACKSONVILLE, FL 32258-2615
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY10781
FL
103TC0700X
Clinical Psychologist
PY10781
FL
Other
Enumeration date
03/02/2021
Last updated
09/10/2025
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