Individual
MRS. DUSTIN LEIGH FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D., M.A., M.S.
Contact information
Practice address
426 N MERIDIAN, PUYALLUP, WA 98371-8636
(714) 494-3706
Mailing address
426 N MERIDIAN, PUYALLUP, WA 98371-8636
(714) 494-3706
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
67378
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01245407
MEDICAL
CA
Enumeration date
08/08/2011
Last updated
04/08/2024
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