Individual
JAMEION BLANTON FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
(843) 347-3959
Mailing address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
(843) 347-3959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11181
SC
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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