Individual
BRENDA FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1942 NW KEARNEY ST STE 32, PORTLAND, OR 97209-1426
(503) 389-3302
Mailing address
1942 NW KEARNEY ST STE 32, PORTLAND, OR 97209-1426
(503) 389-3302
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3404
OR
Other
Enumeration date
05/18/2014
Last updated
05/18/2014
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