Individual
ALLEN J FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADC
Contact information
Practice address
1020 LAND BANK ST, IDAHO FALLS, ID 83402-1809
(208) 520-6992
(208) 522-6165
Mailing address
1020 LAND BANK ST, IDAHO FALLS, ID 83402-1809
(208) 520-6992
(208) 522-6164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11457
ID
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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