Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810001231 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810001231 | VA |
NPI | 1003849860 |
---|---|
Provider Name | Dr. Alan Frank Kleinkopf |
First Address | Richmond, VA 23226-1105 |
Second Address | Richmond, VA 23226-1105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
028286 | ANTHEM (01) | VA |
R60360 | (02) | VA |