Individual
MR. BRYAN LYNN FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW
Contact information
Practice address
220 BAGLEY STE 1100, DETROIT, MI 48266-0001
(313) 961-7990
(313) 961-6274
Mailing address
43100 12 OAKS CRESCENT DR APT 6011, NOVI, MI 48377-3438
(734) 730-2007
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801087382
MI
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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