Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 0810004653 | VA |
NPI | 1417209164 |
---|---|
Provider Name | Dr. Satpuran Singh Khalsa |
First Address | Alexandria, VA 22310-2553 |
Second Address | Alexandria, VA 22310-2553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2012 |
Last Update Date | 04/10/2012 |