Individual
DR. JUANITA J FUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
805 N WILLOW AVE, SUITE 300, COOKEVILLE, TN 38501-1751
(931) 526-8000
(931) 526-8000
Mailing address
3115 FOWLER MONTGOMERY RD, COOKEVILLE, TN 38506-6469
(931) 526-8000
(931) 526-8000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P0000001338
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103919
CIGNA
TN
01
—
3094270
BLUE CROSS BLUE SHIELD
TN
Enumeration date
12/14/2006
Last updated
07/08/2007
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