Provider Demographics
NPI:1972723500
Name:NADLER, SUZANNA T (LPC)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:T
Last Name:NADLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ZM SUZANNA
Other - Middle Name:
Other - Last Name:NADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 763
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-0763
Mailing Address - Country:US
Mailing Address - Phone:541-535-3338
Mailing Address - Fax:541-535-4910
Practice Address - Street 1:9820 WAGNER CREEK RD
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-7803
Practice Address - Country:US
Practice Address - Phone:541-535-3338
Practice Address - Fax:541-535-4910
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional