| NPI | 1760647663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM E FOWLER Owner 985-781-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 665) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2008-07-21 |