Doctor Name: | MARK T BARISA |
NPI Number: | 1417960840 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 20042107A |
Business Practice Address: | 909 N Washington Ave Baylor Institute For Rehabilitation-neuropsychology Dallas, TX - 752461520 |
Business Phone Number: | 2148208755 |
Business Fax Number: | 2148208744 |
Mailing Address: | 909 N Washington Ave, Baylor Institute For Rehabilitation-neuropsychology DALLAS |
State: | TX |
Postal Code: | 752461520 |
Phone Number: | 2148208755 |
Fax Number: | 2148208744 |
NPI Enumeration Date: | 08/15/2006 |
NPI Last Update Date: | 02/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 20042107A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |