Individual
CAROL RENE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
SERE DET, 1-145TH AVN REGT, BLDG 750, 3RD AVE, FORT RUCKER, AL 32326
(334) 255-0441
Mailing address
302 WASHINGTON AVE, ENTERPRISE, AL 36330-4411
(334) 406-9778
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1277
AL
Other
Enumeration date
09/26/2005
Last updated
06/06/2012
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