Individual
CASEY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 GEORGIA ST STE 355, VALLEJO, CA 94590-5971
(707) 558-8195
Mailing address
301 GEORGIA ST STE 355, VALLEJO, CA 94590-5971
(707) 558-8195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/26/2008
Last updated
11/26/2008
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