Individual
DR. MADELINE ANNE IVANCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2342 COLONY CROSSING PL, MIDLOTHIAN, VA 23112-4280
(804) 639-1112
Mailing address
9097 ATLEE STATION RD, SUITE 219, MECHANICSVILLE, VA 23116-2525
(804) 730-0432
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004312
VA
Other
Enumeration date
11/07/2010
Last updated
11/09/2010
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