Individual
ANYA GENIESER-DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
80 GRAVEL PIKE UNIT B, RED HILL, PA 18076-1428
(484) 624-2415
(215) 679-2875
Mailing address
1848 CANDLEWYCK LN, GREEN LANE, PA 18054-2047
(484) 624-2415
(215) 679-2875
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS015501
PA
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
PS015501
PA
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS015501
LICENSE
PA
Enumeration date
10/02/2006
Last updated
07/21/2022
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