Individual
ANASTASIA IVANENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7 HAYES LN, LEXINGTON, MA 02420-3703
(617) 930-0906
Mailing address
7 HAYES LN, LEXINGTON, MA 02420-3703
(617) 930-0906
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
9839
MA
Other
Enumeration date
12/28/2006
Last updated
07/30/2014
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