Individual
FESTUS O IMASUEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5653 FRIST BLVD, SUITE 740, HERMITAGE, TN 37076-2062
(615) 884-5669
(615) 884-5670
Mailing address
PO BOX 249, HERMITAGE, TN 37076-0249
(615) 884-5669
(615) 884-5670
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LPC0000000847
TN
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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