Individual
MRS. CECILIA D FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1500 EAST WOODROW WILSON DRIVE, JACKSON, MS 39216
(601) 364-1295
(601) 364-1394
Mailing address
13015 LEBANON PINEGROVE ROAD, TERRY, MS 39170
(601) 878-2461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0088
MS
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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