Provider Demographics
NPI:1851871305
Name:FUSSELL, JOANNA H (BCBA)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:H
Last Name:FUSSELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6385 STAGE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3730
Mailing Address - Country:US
Mailing Address - Phone:901-287-3024
Mailing Address - Fax:
Practice Address - Street 1:6385 STAGE RD STE 1
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3730
Practice Address - Country:US
Practice Address - Phone:901-287-3024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician