Individual
DR. MARIO DI BIASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7149 BLACKSHEEP RUN, FT. CAMPBELL, KY 42223
(270) 798-8727
Mailing address
7001 WESTWIND DR STE 170, EL PASO, TX 79912-1778
(915) 745-7134
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071006045
IL
103TC0700X
Clinical Psychologist
37800
TX
103TC0700X
Clinical Psychologist
Primary
3803
TN
Other
Enumeration date
01/11/2007
Last updated
10/03/2024
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