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Individual

ART EUGENE FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LPC, CSAT, CAMT

Contact information

Practice address
54 LUMPKIN CAMPGROUND RD S, SUITE 100, DAWSONVILLE, GA 30534-6196
(706) 216-4735
(706) 216-7909
Mailing address
54 LUMPKIN CAMPGROUND RD S, SUITE 100, DAWSONVILLE, GA 30534-6196
(706) 216-4735
(706) 216-7909

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006572
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003126063A
GA
05
003126063B
GA
Enumeration date
10/17/2011
Last updated
06/06/2013
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