Individual
MS. MELINDA MICHELLE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CCTP
Contact information
Practice address
1350 MYRTLE AVE, LAS CRUCES, NM 88001-5341
(575) 405-7323
Mailing address
1350 MYRTLE AVE, LAS CRUCES, NM 88001-5341
(575) 405-7323
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2024-0166
NM
Other
Enumeration date
11/27/2019
Last updated
04/19/2024
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