Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 2831 | OH |
N | 103T00000X | Psychologist | 2831 | OH |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2831 | OH |
NPI | 1023227469 |
---|---|
Provider Name | Dr. Thomas F. Barrett |
First Address | Chicago, IL 60610 |
Second Address | Chicago, IL 60610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 25/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000181058 | BC BS NUMBER (01) | OH |
0454799 | (05) | OH |