| Doctor Name: | MRS. SUZANNE PETROSIAN |
| NPI Number: | 1326487802 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | MFTI74872 |
| Business Practice Address: | 2919 Los Olivos Ln La Crescenta, CA - 912142814 |
| Business Phone Number: | 6267928797 |
| Business Fax Number: | 6267928798 |
| Mailing Address: | 2919 Los Olivos Ln, LA CRESCENTA |
| State: | CA |
| Postal Code: | 912142814 |
| Phone Number: | 6267928797 |
| Fax Number: | 6267928798 |
| NPI Enumeration Date: | 06/18/2013 |
| NPI Last Update Date: | 06/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | MFTI74872 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |