Individual
PETER RANDOLPH TERRANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
31 6TH ST, MALONE, NY 12953-1246
(315) 296-8344
Mailing address
37 CHRISTINE LN, HOGANSBURG, NY 13655-2167
(315) 296-8344
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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