Provider Demographics
NPI:1811412000
Name:YSERN SOLA, NOELIA ALEJANDRA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NOELIA
Middle Name:ALEJANDRA
Last Name:YSERN SOLA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8074 GATE PKWY W APT 1308
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1617
Mailing Address - Country:US
Mailing Address - Phone:904-414-3812
Mailing Address - Fax:
Practice Address - Street 1:8074 GATE PKWY W APT 1308
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1617
Practice Address - Country:US
Practice Address - Phone:904-414-3812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11272103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist