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Individual

JACKELINE FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 520-7230
Mailing address
1706 WAGON WHEEL DR, LITTLE ROCK, AR 72211-4172
(501) 520-7230

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10053-M
AR

Other

Enumeration date
02/08/2022
Last updated
02/08/2022
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