Provider Demographics
NPI:1568565851
Name:PAQUETTE, TERRENCE (PSYD)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:
Last Name:PAQUETTE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 E MCGOVERN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1923
Mailing Address - Country:US
Mailing Address - Phone:717-431-9692
Mailing Address - Fax:
Practice Address - Street 1:32 E MCGOVERN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-1923
Practice Address - Country:US
Practice Address - Phone:717-431-9692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical