Individual
AMY LYNN FOWKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6200 CRESTWOOD STA, SUITE A, CRESTWOOD, KY 40014-7418
(502) 243-2622
(502) 243-2692
Mailing address
10408 SHADOW RIDGE LN, LOUISVILLE, KY 40241-1299
(412) 770-4181
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2011-100
KY
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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