Provider Demographics
NPI:1083819163
Name:TRISKA, BRUCE STEVEN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:STEVEN
Last Name:TRISKA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PARKER SQ
Mailing Address - Street 2:SUITE 290B
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7427
Mailing Address - Country:US
Mailing Address - Phone:214-513-2100
Mailing Address - Fax:
Practice Address - Street 1:3520 NW 66TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-2106
Practice Address - Country:US
Practice Address - Phone:214-513-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK00604106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist