Individual
MS. ALEGRA N FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
102 E GREEN BAY ST STE 101, SHAWANO, WI 54166-2444
(715) 280-8130
(715) 280-8138
Mailing address
102 E GREEN BAY ST STE 101, SHAWANO, WI 54166-2444
(715) 280-8130
(715) 280-8138
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9136-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1637
—
WI
Enumeration date
07/25/2019
Last updated
12/08/2022
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