Individual
CHRISTIE A FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4403 74TH ST, LUBBOCK, TX 79424-2307
(806) 795-0668
Mailing address
5503 92ND ST, LUBBOCK, TX 79424-4509
(817) 793-6950
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
9751
TX
235Z00000X
Speech-Language Pathologist
Primary
114038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148686201
—
TX
Enumeration date
02/22/2008
Last updated
08/05/2021
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