Provider Demographics
NPI:1518018092
Name:DANNEMILLER, EUGENE ALOYSIUS (PHD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:ALOYSIUS
Last Name:DANNEMILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 HUNTER MILL RD
Mailing Address - Street 2:OAKTON PROFESSIONAL CENTER, SUITE #21
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1716
Mailing Address - Country:US
Mailing Address - Phone:703-938-6866
Mailing Address - Fax:703-938-6203
Practice Address - Street 1:2915 HUNTER MILL RD
Practice Address - Street 2:OAKTON PREFESSIONAL CENTER, SUITE 21
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-1716
Practice Address - Country:US
Practice Address - Phone:703-938-6867
Practice Address - Fax:703-938-6203
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000925103TA0400X, 103TC0700X, 103TC2200X, 103TF0200X, 103T00000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy