Individual
CHRISTINA ELYSE DERENGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4417 N 6TH ST, PHILADELPHIA, PA 19140-2319
(215) 302-3600
Mailing address
1423 N MYRTLEWOOD ST, PHILADELPHIA, PA 19121-3614
(480) 220-1624
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS018521
PA
Other
Enumeration date
11/15/2018
Last updated
01/07/2025
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