Individual
MS. LISA DAWN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCAS-A, NCCPSS
Contact information
Practice address
1175 REVOLUTION MILL DR STE 15, GREENSBORO, NC 27405-5080
(919) 794-3686
Mailing address
1175 REVOLUTION MILL DR STE 15, GREENSBORO, NC 27405-5080
(919) 794-3686
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-28014
NC
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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