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Individual

JESSICA FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CASAC-T

Contact information

Practice address
168 LINCOLN AVE, SYRACUSE, NY 13204-4116
(315) 218-6492
(315) 214-5764
Mailing address
168 LINCOLN AVE, SYRACUSE, NY 13204-4116
(315) 218-6492
(315) 214-5764

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
39005
NY

Other

Enumeration date
04/11/2024
Last updated
04/11/2024
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