Individual
CARLA FOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
Mailing address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 275-3222
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
F400-101-83-728-1
FL
104100000X
Social Worker
F400-101-83-728-1
FL
Other
Enumeration date
01/24/2019
Last updated
11/26/2019
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