Individual
DR. ANTHONY DAVID MANGIAFICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, CNS
Contact information
Practice address
2552 ALDRIDGE AVE, SOUTH CHESTERFIELD, VA 23834-5306
(804) 735-9595
Mailing address
2552 ALDRIDGE AVE, SOUTH CHESTERFIELD, VA 23834-5306
(804) 735-9595
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0015000629
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11570632
CAQH
VA
05
—
5510571
—
VA
Enumeration date
05/12/2006
Last updated
07/25/2021
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