IndividualActive
Alicia Ayala Laconich, PH.D IN PSYCHOLOGY
NPI 1376138495 · Clinical Neuropsychologist · Jacksonville, FL
Provider details
- NPI number
- 1376138495
- Entity type
- Individual
- Primary specialty
- Clinical NeuropsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D IN PSYCHOLOGY
- Sex
- Female
- Sole proprietor
- No
- License
- PY10781 (FL)
Practice location
12574 Flagler Center Blvd
Ste 101
Jacksonville, FL 32258-2615
Phone: (904) 374-4276
Fax: (888) 495-1508
Mailing address
12574 Flagler Center Blvd Ste 101
Jacksonville, FL 32258-2615
Registry dates
- Enumerated
- 2021-03-02
- Last updated
- 2025-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.