Individual
MAKAYLA JEAN FOWLKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
600 NEWTON RD, RALEIGH, NC 27615-6214
(919) 928-5928
Mailing address
35 MERLE WAY, WENDELL, NC 27591-6122
(731) 676-8963
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13798
NC
Other
Enumeration date
02/02/2021
Last updated
03/02/2026
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