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1386356236
CRYSTAL LORRAINE FOWLKES
NORFOLK, VA
NPI
1386356236
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-12-21
Last Update Date
2022-12-21
Business Address
CRYSTAL LORRAINE FOWLKES BT
6325 N CENTER DR STE 121
NORFOLK, VA 23502-0012
Phone number: 757-901-0646
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Mailing Address
CRYSTAL LORRAINE FOWLKES BT
5812 DUNKIRK ST
PORTSMOUTH, VA 23703-3128
Phone number: 757-578-6003
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