Doctor Name: | ABIGAIL FOWLER |
NPI Number: | 1033502976 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMFTA, MHP |
License Number: | MG60312341 |
Business Practice Address: | 1033 Sw 152nd St Burien, WA - 981661845 |
Business Phone Number: | 2066120741 |
Business Fax Number: | |
Mailing Address: | 1033 Sw 152nd St, BURIEN |
State: | WA |
Postal Code: | 981661845 |
Phone Number: | 2066120741 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2015 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MG60312341 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |