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Individual

DR. PURAN DOUGLASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
8233 OLD COURTHOUSE RD STE 102, VIENNA, VA 22182-3816
(703) 924-2370
(703) 924-2374
Mailing address
8233 OLD COURTHOUSE RD STE 102, VIENNA, VA 22182-3816
(703) 924-2370
(703) 924-2374

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
0810004653
VA
103TC0700X
Clinical Psychologist
Primary
0810004653
VA

Other

Enumeration date
10/04/2012
Last updated
01/02/2024
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