Individual
SAMUEL WALLACE PELOQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
ISW03231
RI
1041C0700X
Clinical Social Worker
Primary
ISW023231
RI
Other
Enumeration date
05/22/2022
Last updated
04/30/2026
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