Individual
STACY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1395 N HIGHWAY DR, FENTON, MO 63026-1929
(407) 810-8531
Mailing address
77 E LAKE RD, FENTON, MO 63026-5010
(407) 810-8531
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2025003174
MO
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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