Individual
ELLEN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
582 SE 7TH AVE STE B, CRYSTAL RIVER, FL 34429-4840
(352) 228-8829
Mailing address
3404 N LECANTO HWY STE D, BEVERLY HILLS, FL 34465-3569
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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