Organization
MODERN PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PURAN S KHALSA PSYD (LICENSED PSYCHOLOGIST)
(415) 235-9982
Entity
Organization
Contact information
Practice address
6177 GROVEDALE CT STE 100, ALEXANDRIA, VA 22310-2553
(703) 924-2370
(703) 924-2374
Mailing address
6177 GROVEDALE CT STE 100, ALEXANDRIA, VA 22310-2553
(703) 924-2370
(703) 924-2374
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
0810004653
VA
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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