Healthcare Provider Details

I. General information

NPI: 1205745015
Provider Name (Legal Business Name): EDEN LAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 JEANETTE LANCASTER WAY
CHARLOTTESVILLE VA
22903-3387
US

IV. Provider business mailing address

1301 N TROY ST APT 913
ARLINGTON VA
22201-2590
US

V. Phone/Fax

Practice location:
  • Phone: 434-297-6600
  • Fax:
Mailing address:
  • Phone: 860-576-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: