Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 665 | LA |
Y | 103TP0016X | Prescribing (Medical) | MP000033 | LA |
NPI | 1033260849 |
---|---|
Provider Name | Dr. William E Fowler |
First Address | Slidell, LA 70458-8601 |
Second Address | Metairie, LA 70002-7414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 17/01/2014 |