Individual
STEPHANIA MARICE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6450 WEST 12TH, LITTLE ROCK, AR 72204
(501) 666-8686
Mailing address
356 E BOLLING AVE, MONTICELLO, AR 71655-5606
(501) 666-8686
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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