Individual
ROBERT FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
25 MIDDLE ST, PORTLAND, ME 04101-4869
(207) 232-4112
Mailing address
15 HIGHVIEW DR, NEW GLOUCESTER, ME 04260-4034
(207) 232-4112
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8950
ME
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
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