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Individual

VAN AIKEN DEBLIEUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5477 MOORETOWN RD, WILLIAMSBURG, VA 23188-2108
(757) 565-0106
Mailing address
5477 MOORETOWN RD, WILLIAMSBURG, VA 23188-2108

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
7699
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
7699
NC
363A00000X
Physician Assistant
Primary
0110004783
VA

Other

Enumeration date
02/24/2010
Last updated
12/31/2014
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