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Individual

MATTHEW FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
406 THE HL, PORTSMOUTH, NH 03801-3736
(978) 432-9560
Mailing address
406 THE HL, PORTSMOUTH, NH 03801-3736

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
219
NH
171M00000X
Case Manager/Care Coordinator
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
99003227
NH
Enumeration date
09/28/2012
Last updated
05/01/2019
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