Individual
RYAN PAUL FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1244 CLAIRMONT RD STE 204, DECATUR, GA 30030-1263
(404) 663-1650
Mailing address
3651 BONNIE GLENN LN, TUCKER, GA 30084-8302
(404) 936-4365
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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