Individual
MARRIOTT J FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9005 S HUDSON AVE, TULSA, OK 74137-3576
(918) 360-7014
(866) 310-4081
Mailing address
9005 S HUDSON AVE, TULSA, OK 74137-3576
(918) 360-7014
(866) 310-4081
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1071
OK
Other
Enumeration date
04/10/2019
Last updated
06/11/2019
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