Individual
DR. ROSS FULTON BARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D, LP
Contact information
Practice address
12301 WHITEWATER DR STE 101, MINNETONKA, MN 55343-4157
(952) 999-6097
(952) 426-0508
Mailing address
413 MADISON ST, ANOKA, MN 55303-2518
(612) 719-8674
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6040
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP6040
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851775308
—
MN
Enumeration date
07/15/2015
Last updated
01/26/2021
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