Individual
MRS. LATOSHA R FOWLKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1260 LYNFIELD PL, SAINT LOUIS, MO 63147-1516
(314) 565-6822
Mailing address
1260 LYNFIELD PL, SAINT LOUIS, MO 63147-1516
(314) 565-6822
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149.019998
IL
101YM0800X
Mental Health Counselor
2019003940
MO
Other
Enumeration date
02/27/2018
Last updated
01/02/2025
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