Individual
SUSANNE FINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., RN, CNS
Contact information
Practice address
1117 E MAIN ST, MEDFORD, OR 97504-7404
(541) 245-1123
Mailing address
1117 E MAIN ST, MEDFORD, OR 97504-7404
(541) 245-1123
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1546
OR
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
200870007CNS-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#1546
PSYCHOLOGIST
OR
01
—
200870007CNS-PP
CLINICAL NURSE PRACTTIONER/ARNP
OR
Enumeration date
12/06/2005
Last updated
01/09/2013
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