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NPI Code Detail

MEDICARE: DOUGLAS DANA GONCZ CPS

MEDICARE: DOUGLAS DANA GONCZ CPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist
2225600000XDance Therapist
3225700000XMassage Therapist
4225CA2500XAssistive Technology Supplier Rehabilitation Counselor
5172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1659534493
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS DANA GONCZ CPS
Provider Business Mailing Address
First Line : PO BOX 4394
Second Line :
City : SEVEN CORNERS
State : VA
Zip : 22044-0394
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3041 PATRICK HENRY DR 2
Second Line : THE 4 BUTTON IS STICKY
City : SEVEN CORNERS
State : VA
Zip : 22044-2536
Country : US
Telephone Number : 703-534-0870
Fax Number : 571-395-3575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2008
Last Update Date : 04/07/2025

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Directions to “ DOUGLAS DANA GONCZ CPS” Practice Location

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