Individual
DANIELLE FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
324 WALKER AVE, GRAHAM, NC 27253-2426
(336) 226-6449
Mailing address
1018 MOODY ST, GREENSBORO, NC 27401-4213
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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