Provider Demographics
NPI:1285686444
Name:DONCHENKO, NADIA (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:DONCHENKO
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 DORON LN
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-1214
Mailing Address - Country:US
Mailing Address - Phone:952-833-0830
Mailing Address - Fax:
Practice Address - Street 1:6308 DORON LN
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-1214
Practice Address - Country:US
Practice Address - Phone:952-833-0830
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4192103TC0700X
MNLP 4192103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic