Individual
DR. MILLICENT ROSE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D., CCC-A
Contact information
Practice address
30 MATTHEWS ST STE 203, GOSHEN, NY 10924-1985
(845) 294-8544
Mailing address
55 TERRACE LN, BLAUVELT, NY 10913-1333
(845) 709-7167
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
003037-01
NY
231H00000X
Audiologist
41YA00115300
NJ
Other
Enumeration date
08/09/2021
Last updated
02/27/2023
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