Individual
ALYSSA FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-9612
Mailing address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
LA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
05/23/2025
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