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Individual

WILLIAM LEE FOWLKES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1830 DESTINY LN STE 110, BOWLING GREEN, KY 42104-1088
(270) 904-6567
Mailing address
1103 HOMESTEAD CT, BOWLING GREEN, KY 42104-4122
(270) 535-4516

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252309
KY

Other

Enumeration date
11/22/2023
Last updated
02/16/2024
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