Fine, Susanne

Fine, Susanne is an sole proprietor health care provider with primary practice located at 1117 E Main St , Medford OR 97504-7404. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Fine, Susanne can be contacted via phone (541) 245-1123.

Contact Information

Primary practice address
1117 E Main St Medford OR 97504-7404
Phone: (541) 245-1123
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1546 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X 200870007CNS-PP Oregon

Profile Details

NPI number 1720062490
LBN Legal business name Fine, Susanne
Credentials PSY.D., RN, CNS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2005
Last updated Jan 9th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720062490 NPPES
Oregon Other #1546 PSYCHOLOGIST
Oregon Other 200870007CNS-PP PSYCHOLOGIST

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