Individual
ANNA VLADIMIROVNA ICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8310 MIDLOTHIAN TPKE, NORTH CHESTERFIELD, VA 23235-5163
(804) 503-9975
Mailing address
8310 MIDLOTHIAN TPKE, NORTH CHESTERFIELD, VA 23235-5163
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701012213
VA
Other
Enumeration date
02/20/2023
Last updated
08/25/2023
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