Individual
JILLIAN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
880 6TH ST S, SUITE 420, ST PETERSBURG, FL 33701-4827
(727) 767-8477
Mailing address
234 3RD AVE N, #203, ST PETERSBURG, FL 33701-3322
(574) 612-5293
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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