Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 0810000925 | VA |
N | 103T00000X | Psychologist | 0810000925 | VA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 0810000925 | VA |
N | 103G00000X | Clinical Psychologist | 0810000925 | VA |
N | 103TC0700X | Clinical Psychologist | 0810000925 | VA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 0810000925 | VA |
N | 103TF0200X | Forensic Psychologist | 0810000925 | VA |
N | 103TP2701X | Group Psychotherapist | 0810000925 | VA |
NPI | 1518018092 |
---|---|
Provider Name | Dr. Eugene Aloysius Dannemiller |
First Address | Oakton, VA 22124-1716 |
Second Address | Oakton, VA 22124-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2007 |
Last Update Date | 08/07/2007 |