Healthcare Provider Details

I. General information

NPI: 1437136991
Provider Name (Legal Business Name): DANIEL P BARRON PSYD, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11455 VIKING DR STE 300
EDEN PRAIRIE MN
55344-7251
US

IV. Provider business mailing address

6465 WAYZATA BLVD STE 315
ST LOUIS PARK MN
55426-1728
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-2498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberLP3941
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: