Basic Information
| Provider Information | |||||||||
| NPI: | 1548538614 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOWLER | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 JOHN CLARKE ROAD, CHILD & FAMILY | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028425641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018492300 | ||||||||
| FaxNumber: | 4018484156 | ||||||||
| Practice Location | |||||||||
| Address1: | 31 JOHN CLARKE ROAD, CHILD & FAMILY | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028425641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018492300 | ||||||||
| FaxNumber: | 4018484156 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2011 | ||||||||
| LastUpdateDate: | 12/05/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MHC00526 | RI | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.