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Individual

DR. JON MICHAEL BUYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1111 W 6TH ST STE 111, LOS ANGELES, CA 90017-1823
(323) 404-1027
(323) 340-8298
Mailing address
625 FAIR OAKS AVE STE 200, SOUTH PASADENA, CA 91030-2694
(323) 341-5580
(323) 340-8298

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301001760
MI
103TS0200X
School Psychologist
235724
MI

Other

Enumeration date
02/23/2010
Last updated
02/23/2010
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