Individual
DR. MATTHEW BENNETT FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1000 E 24TH ST, KANSAS CITY, MO 64108-2776
(816) 512-7293
(816) 512-7252
Mailing address
1000 E 24TH ST, KANSAS CITY, MO 64108-2776
(816) 512-7293
(816) 512-7252
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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