Healthcare Provider Details

I. General information

NPI: 1114916327
Provider Name (Legal Business Name): ALFRED ROBERT BARROW PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

494 S EMERSON AVE SUITE B
GREENWOOD IN
46143-1912
US

IV. Provider business mailing address

261 INNISBROOKE DR
GREENWOOD IN
46142-9111
US

V. Phone/Fax

Practice location:
  • Phone: 317-888-0581
  • Fax: 317-888-6221
Mailing address:
  • Phone: 317-885-1387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number20040530
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: