Individual
DIANE FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
(704) 972-2086
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
(704) 972-2086
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2747
NC
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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