Individual
JESSICA FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
5536 HOLIDAY RD, MINNETONKA, MN 55345-5414
(612) 716-0809
Mailing address
5536 HOLIDAY RD, MINNETONKA, MN 55345-5414
(612) 716-0809
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4379
MN
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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