| Peninsula Consulting Services, Inc. | |
|
104 Williamsport Cir Suite C Salisbury MD 21804-6400 | |
| (443) 859-8699 | |
| (443) 859-8747 |
| Full Name | Peninsula Consulting Services, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 104 Williamsport Cir, Salisbury, Maryland |
| Authorized Official Name and Position | Tyantha G Randall (OWNER) |
| Authorized Official Contact | 4438598699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Consulting Services, Inc. 104 Williamsport Cir Suite C Salisbury MD 21804-6400 Ph: (443) 859-8699 | Peninsula Consulting Services, Inc. 104 Williamsport Cir Suite C Salisbury MD 21804-6400 Ph: (443) 859-8699 |
| NPI Number | 1356613491 |
|---|---|
| Provider Enumeration Date | 02/06/2012 |
| Last Update Date | 02/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356613491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 13117 (Maryland) | Primary |
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