Individual
MR. BOISEY J BRISTO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6161 AMELIA AVE., 1315, FORT WORTH, TX 76123-2141
(484) 544-9198
Mailing address
6161 AMELIA AVE., 1315, FORT WORTH, TX 76123-2141
(484) 544-9198
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
75700
TX
101YP2500X
Professional Counselor
Primary
75700
TX
Other
Enumeration date
05/15/2018
Last updated
08/18/2023
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