THEODORE WILLIAM FOWLER

SAN JOSE, CA
NPI1487162962
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1208500715)
Enumeration Date2018-01-18
Last Update Date2018-01-18
Business Address
THEODORE WILLIAM FOWLER
650 S BASCOM AVE
SAN JOSE, CA 95128-2601
Phone number: 408-283-8555
Mailing Address
THEODORE WILLIAM FOWLER
650 S BASCOM AVE
SAN JOSE, CA 95128-2601
Phone number: 408-283-8555