Individual
MARYHELEN I PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
401 4TH STREET, FOSSIL, OR 97830
(541) 763-2746
Mailing address
48500 HWY 19, FOSSIL, OR 97830
(541) 763-4315
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/16/2006
Last updated
09/11/2025
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