Provider Demographics
NPI:1205328572
Name:BARR, DENNIS (EDD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:BARR
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 W CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4335
Mailing Address - Country:US
Mailing Address - Phone:617-872-7184
Mailing Address - Fax:
Practice Address - Street 1:554 WASHINGTON ST STE 12
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-6473
Practice Address - Country:US
Practice Address - Phone:617-735-1674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-03
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical