Provider Demographics
NPI:1467635441
Name:REAUME, DANA P (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:P
Last Name:REAUME
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 BRISTLECONE LN
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1847
Mailing Address - Country:US
Mailing Address - Phone:423-956-1273
Mailing Address - Fax:
Practice Address - Street 1:74 BRISTLECONE LN
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1847
Practice Address - Country:US
Practice Address - Phone:706-726-3738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001993103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical