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Individual

DR. FRED W FUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
210 WASHINGTON ST NW, STE. 200, GAINESVILLE, GA 30501-3672
(770) 536-3902
(770) 536-3902
Mailing address
210 WASHINGTON ST NW, STE. 200, GAINESVILLE, GA 30501-3672
(770) 536-3902
(770) 536-3902

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1302
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00378111A
GA
Enumeration date
07/04/2006
Last updated
07/08/2007
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