Individual
HEATHER LYNN FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
302 W CENTRAL AVE, AVIS, PA 17721-8901
(570) 502-5989
Mailing address
1039 PARK AVE., PO BOX 316, WOOLRICH, PA 17779
(570) 502-5989
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC004114
PA
Other
Enumeration date
07/18/2006
Last updated
07/21/2021
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