Provider Demographics
NPI:1811102908
Name:BARR, MARY ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:BARR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-5025
Mailing Address - Country:US
Mailing Address - Phone:415-383-9245
Mailing Address - Fax:415-389-0396
Practice Address - Street 1:277 CASCADE DR
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-5025
Practice Address - Country:US
Practice Address - Phone:415-383-9245
Practice Address - Fax:415-389-0396
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPG 5913103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)