Individual
SAMUEL CODY PETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1830 HILLANDALE RD, DURHAM, NC 27705-2670
(919) 286-0411
Mailing address
111 W EDGEWOOD DR, DURHAM, NC 27704-3119
(618) 979-1186
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6196
NC
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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