Individual
ANN S DERISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LSW
Contact information
Practice address
938 PENN ST, READING, PA 19602
(610) 478-8088
(610) 478-8176
Mailing address
200 NORTH 7TH ST, LEBANON, PA 17046
(717) 273-1710
(717) 273-1416
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW125062
PA
101YM0800X
Mental Health Counselor
SW125062
PA
1041C0700X
Clinical Social Worker
Primary
CW-015993
PA
Other
Enumeration date
03/28/2006
Last updated
08/04/2008
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