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General NPI Number Information
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NPI Number | 1629381793
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Entity Type | Individual
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Provider Name | ALISON ANN FEDIO PH.D., PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 8996 BURKE LAKE ROAD SUITE 100
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City | BURKE
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State | VA
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Zip | 22015-1946
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Country | US
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Telephone | 703-978-9781
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Fax | 703-426-4223
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Provider Business Mailing Address
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Address Line | 9408 RAINTREE RD
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City | BURKE
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State | VA
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Zip | 22015-1946
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Country | US
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Telephone | 703-309-6004
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Fax | 703-426-4223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 0810003682
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810003682
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License Number State | VA
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