| NPI | 1124260633 |
|---|---|
| Former Name | HEIDI L FOWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2901) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4152) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2012-10-17 |