| Doctor Name: | CAROL RENE FOWLER |
| NPI Number: | 1023004884 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 1277 |
| Business Practice Address: | Sere Det, 1-145th Avn Regt Bldg 750, 3rd Ave Fort Rucker, AL - 32326 |
| Business Phone Number: | 3342550441 |
| Business Fax Number: | |
| Mailing Address: | 302 Washington Ave, ENTERPRISE |
| State: | AL |
| Postal Code: | 363304411 |
| Phone Number: | 3344069778 |
| Fax Number: | |
| NPI Enumeration Date: | 09/26/2005 |
| NPI Last Update Date: | 06/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1277 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |