Individual
FREDERICK FOWLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
429 BILLINGSLEY RD, CHARLOTTE, NC 28211-1007
(704) 445-6900
(980) 406-3547
Mailing address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
(704) 376-3384
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSAC-21797
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSAC-21797
NCSAPPB
NC
Enumeration date
02/07/2017
Last updated
02/07/2017
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