Organization
AEDA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE ALLEN JR. CSAC,NCAC II (MBR)
(703) 615-7574
Entity
Organization
Contact information
Practice address
10723 MAIN ST, FAIRFAX, VA 22030-6905
(703) 615-7475
Mailing address
6239 SUMMER POND DR APT B, CENTREVILLE, VA 20121-4631
(703) 615-7475
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710103012
VA
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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