Doctor Name: | EUGENE N YEMOFIO |
NPI Number: | 1215293931 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 2017 Lindsey Gabriel Dr Henrico, VA - 232315799 |
Business Phone Number: | 8044337338 |
Business Fax Number: | |
Mailing Address: | 2017 Lindsey Gabriel Dr, HENRICO |
State: | VA |
Postal Code: | 232315799 |
Phone Number: | 8044337338 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2012 |
NPI Last Update Date: | 04/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |