Individual
MARK T BARISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4645 AVON LN STE 285, FRISCO, TX 75033-1609
(972) 632-0033
(214) 501-0809
Mailing address
PO BOX 6001, FRISCO, TX 75035-0225
(469) 400-6230
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
34011
TX
103TC0700X
Clinical Psychologist
34011
TX
103TC1900X
Counseling Psychologist
34011
TX
103TE1100X
Exercise & Sports Psychologist
34011
TX
103TH0004X
Health Psychologist
34011
TX
103TR0400X
Rehabilitation Psychologist
34011
TX
Other
Enumeration date
08/15/2006
Last updated
12/29/2021
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