Provider Demographics
NPI:1659986800
Name:EUGENIO, ALEX JULIAN DINO (LMT)
Entity Type:Individual
Prefix:MS
First Name:ALEX JULIAN
Middle Name:DINO
Last Name:EUGENIO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 HAWTHORNE DR NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1001
Mailing Address - Country:US
Mailing Address - Phone:202-277-9130
Mailing Address - Fax:
Practice Address - Street 1:3025 HAWTHORNE DR NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1001
Practice Address - Country:US
Practice Address - Phone:202-277-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT1100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist