Provider Demographics
NPI:1033472451
Name:LOMAX, EUGENA
Entity type:Individual
Prefix:MS
First Name:EUGENA
Middle Name:
Last Name:LOMAX
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 1:7827 TOWN SQUARE AVE STE 104-1140
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7197
Mailing Address - Country:US
Mailing Address - Phone:314-614-0039
Mailing Address - Fax:
Practice Address - Street 1:7827 TOWN SQUARE AVE STE 104-1140
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7197
Practice Address - Country:US
Practice Address - Phone:314-614-0039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011038810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional