Individual
VAIBHAV SAPURAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPA, HSP-PA
Contact information
Practice address
1100 W MARKET ST, GREENSBORO, NC 27403-1830
(336) 334-5662
Mailing address
2205 NEW GARDEN RD APT 4617, GREENSBORO, NC 27410-1757
(512) 850-3541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5464
NC
Other
Enumeration date
01/11/2019
Last updated
05/15/2019
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