| NPI | 1124620117 |
|---|---|
| Other Name | BETHANY K FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 202010385NP-PP) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2020-11-13 |