Provider Demographics
NPI:1396306155
Name:DUJOVNE, EUGENIA INES
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:INES
Last Name:DUJOVNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 SPARROW LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1658
Mailing Address - Country:US
Mailing Address - Phone:954-479-9268
Mailing Address - Fax:
Practice Address - Street 1:1045 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2119
Practice Address - Country:US
Practice Address - Phone:954-479-9268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health