Provider Demographics
NPI:1629381793
Name:FEDIO, ALISON ANN (PHD, PSYD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ANN
Last Name:FEDIO
Suffix:
Gender:F
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 RAINTREE RD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1946
Mailing Address - Country:US
Mailing Address - Phone:703-309-6004
Mailing Address - Fax:703-426-4223
Practice Address - Street 1:8996 BURKE LAKE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1946
Practice Address - Country:US
Practice Address - Phone:703-978-9781
Practice Address - Fax:703-426-4223
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003682103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical