Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY4915 | FL |
Y | 103TC0700X | Clinical Psychologist | PY4915 | FL |
N | 103TA0700X | Adult Development & Aging Psychologist | PY4915 | FL |
N | 103G00000X | Clinical Psychologist | PY4915 | FL |
N | 103TC0700X | Clinical Psychologist | PY4915 | FL |
N | 103TH0100X | Health Service | PY4915 | FL |
NPI | 1508054040 |
---|---|
Provider Name | Amy Elizabeth Barr |
First Address | Sarasota, FL 34239-2635 |
Second Address | Sarasota, FL 34239-2635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 31/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
59693 | BLUE CROSS/BLUE SHIELD (01) | FL |
620005034 | RAILROAD MEDICARE (01) | |
R92177 | (02) | FL |