Individual
PHOENIX K FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11103 PARK RD, LOUISVILLE, KY 40223-2424
(502) 589-8600
Mailing address
10401 LINN STATION RD STE 100, LOUISVILLE, KY 40223-3842
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
256081
KY
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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