Individual
MAYA DERHAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CGC
Contact information
Practice address
750 8TH AVE, FORT WORTH, TX 76104-2515
(682) 885-2170
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
23467
TX
170300000X
Genetic Counselor (M.S.)
Primary
—
—
Other
Enumeration date
10/30/2025
Last updated
05/06/2026
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