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Individual

MR. KEITH BAUGUS FUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LMFT

Contact information

Practice address
2855 SUMMER OAKS DR, BARTLETT, TN 38134-3812
(901) 382-3888
Mailing address
2855 SUMMER OAKS DR, BARTLETT, TN 38134-3812
(901) 382-3888

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
457
TN
106H00000X
Marriage & Family Therapist
Primary
600
TN

Other

Enumeration date
05/07/2009
Last updated
05/07/2009
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