Individual
ANTONINA DEVERUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4641 E ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-2962
Mailing address
3895 FAIRDALE RD, PHILADELPHIA, PA 19154-3439
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC008783
PA
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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