Healthcare Provider Details

I. General information

NPI: 1164334140
Provider Name (Legal Business Name): SATWANT KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 FORBES BLVD STE 110
LANHAM MD
20706-4374
US

IV. Provider business mailing address

12404 WINDING LN
BOWIE MD
20715-1234
US

V. Phone/Fax

Practice location:
  • Phone: 301-499-4240
  • Fax:
Mailing address:
  • Phone: 202-607-6932
  • Fax: 240-455-6847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number210410981
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: