Provider Demographics
NPI:1013297290
Name:FUSON, AMY ROSE (MA)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:ROSE
Last Name:FUSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4610
Mailing Address - Country:US
Mailing Address - Phone:508-567-5350
Mailing Address - Fax:
Practice Address - Street 1:2425 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-4508
Practice Address - Country:US
Practice Address - Phone:508-679-8511
Practice Address - Fax:508-672-2558
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health