Individual
MARY LU FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 W MAIN ST, JACKSONVILLE, AR 72076-4214
(501) 982-0528
(501) 533-6327
Mailing address
2520 W MAIN ST, JACKSONVILLE, AR 72076-4214
(501) 982-0528
(501) 533-6327
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#P8337
AR
Other
Enumeration date
07/12/2011
Last updated
12/01/2011
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