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Individual

BETH FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW, CCM

Contact information

Practice address
2390 WOODLAKE DR STE 380, OKEMOS, MI 48864-6018
(517) 333-7113
Mailing address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346-4824
(248) 620-6400

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801095618
MI

Other

Enumeration date
02/06/2018
Last updated
08/02/2018
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