| NPI | 1083168405 |
|---|---|
| Former Name | ELIZABETH FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180010314) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.010314) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2025-01-25 |