Individual
ZELEYKA FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
51 N ELM ST, WATERBURY, CT 06702-1545
(475) 253-8814
Mailing address
51 N ELM ST, WATERBURY, CT 06702-1545
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
UNLICENSED
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/12/2020
Last updated
07/21/2021
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