Individual
MELISSA FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4120 FAYETTE CORNER DR, SOMERVILLE, TN 38068-4320
(406) 579-8620
Mailing address
11100 OLD HIGHWAY 64 WEST, BOLIVAR, TN 38008
(731) 228-0741
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8725
TN
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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