Individual
LARA FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S MAIN ST STE 10, CONRAD, MT 59425-2532
(406) 201-9414
(406) 278-0330
Mailing address
600 S MAIN ST STE 10, CONRAD, MT 59425-2532
(406) 201-9414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-43400
MT
Other
Enumeration date
01/24/2020
Last updated
04/24/2023
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