Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | KS |
NPI | 1013506963 |
---|---|
Provider Name | Dr. Ashley Marie Fowler |
First Address | Kansas City, KS 66103-2910 |
Second Address | Kansas City, KS 66160-8500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2021 |
Last Update Date | 14/01/2021 |