Provider Demographics
NPI:1942029426
Name:PINEAU, DANIEL (PHD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PINEAU
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 1:5905 COVERDALE WAY APT F
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-5404
Mailing Address - Country:US
Mailing Address - Phone:618-697-5789
Mailing Address - Fax:
Practice Address - Street 1:5905 COVERDALE WAY APT F
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-5404
Practice Address - Country:US
Practice Address - Phone:618-697-5789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008681103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical