Individual
DR. SUSAN H FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
18554 NORTHLAND DR, BIG RAPIDS, MI 49307-8788
(231) 796-3339
Mailing address
PO BOX 511, BIG RAPIDS, MI 49307-0511
(231) 796-3339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301006925
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039129
VALUE OPTIONS
MI
01
—
680E44501
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/18/2007
Last updated
07/17/2013
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