Individual
MELVIN FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901 TOKAY ST NE, ALBUQUERQUE, NM 87107-4927
(615) 559-3624
Mailing address
9927 HAMAKUA ST, DIAMONDHEAD, MS 39525-4433
(615) 559-3624
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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