Individual
LISA J FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
231 E GRAHAM, PRYOR, OK 74361
(918) 825-1405
(918) 825-1406
Mailing address
1727 S JACKSON AVE 25-I, TULSA, OK 74107
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/13/2009
Last updated
05/20/2010
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