Individual
AVA V DERAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8705 GERMANTOWN AVE, PHILADELPHIA, PA 19118-2720
(215) 247-5400
Mailing address
16 E JOHNSON ST APT 4, PHILADELPHIA, PA 19144-1918
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
PA
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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