Individual
DR. MATTHEW BENNETT FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2017002014
MO
103TF0200X
Forensic Psychologist
Primary
2017002014
MO
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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