| NPI | 1407456262 |
|---|---|
| Former Name | DAWN RENEE TEREZ FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 640101875) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401018750) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |