Individual
MELISSA RANAE FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5613 N OAKWOOD RD, ENID, OK 73703-9345
(580) 548-6808
Mailing address
721 LAKE TRAIL DR, ENID, OK 73701-6845
(580) 747-2163
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
4688
OK
Other
Enumeration date
01/05/2011
Last updated
04/15/2024
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