DERRICK FOWLER

WINSTON SALEM, NC
NPI1518369065
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NC  LCAS-16)
Enumeration Date2014-09-16
Last Update Date2019-07-31
Business Address
DERRICK FOWLER LCAS-A
650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101-4304
Phone number: 336-607-8523
Mailing Address
DERRICK FOWLER LCAS-A
868 NEAL RD
REIDSVILLE, NC 27320-0336
Phone number: 336-524-1811
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