Individual
MR. MICHAEL ANTHONY FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
101YM0800X
Contact information
Practice address
906 HILL RD APT 201, LANDOVER, MD 20785-4340
(771) 777-0516
Mailing address
906 HILL RD APT 201, LANDOVER, MD 20785-4340
(771) 777-0516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1019
DC
101YM0800X
Mental Health Counselor
Primary
CAC11019
DC
Other
Enumeration date
12/17/2018
Last updated
09/09/2024
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