Individual
SUZANNE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, CADC-IT
Contact information
Practice address
810 E JACKSON ST, MEDFORD, OR 97504-6773
(541) 500-7111
(541) 507-9118
Mailing address
810 E JACKSON ST, MEDFORD, OR 97504-6773
(541) 500-7111
(541) 507-9118
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1569
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500738443
—
OR
Enumeration date
02/02/2007
Last updated
10/09/2025
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