Doctor Name: | JAMES MICHAEL FOWLER |
NPI Number: | 1467625616 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LPC, NCC, BCPCC |
License Number: | LPC004310 |
Business Practice Address: | 137 Prominence Ct Suite 220 Dawsonville, GA - 305348953 |
Business Phone Number: | 7062164735 |
Business Fax Number: | 7062167909 |
Mailing Address: | 137 Prominence Ct, Suite 220 DAWSONVILLE |
State: | GA |
Postal Code: | 305348953 |
Phone Number: | 7062164735 |
Fax Number: | 7062167909 |
NPI Enumeration Date: | 04/09/2008 |
NPI Last Update Date: | 12/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC004310 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |