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Individual

DR. BROCK L. FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
1560 E CHEVY CHASE DR STE 130, GLENDALE, CA 91206-4140
(336) 327-1496
(415) 296-5299
Mailing address
3308 WINCHESTER DR, GREENSBORO, NC 27406-5836
(336) 327-1496

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20528
CA

Other

Enumeration date
05/18/2007
Last updated
12/23/2022
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