Mary Leslie Wilson Fowler, LPC
NPI #1598916280 in Grenada, Mississippi
Provider Information
- NPI Number
- 1598916280
- Entity Type
- Individual
- Name
- Mary Leslie Wilson Fowler, LPC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Credential
- LPC
- Enumeration Date
- Oct 1, 2008
- Last Updated
- Oct 1, 2008
Practice Location
- Address
- 1800 HILL DR STE E
- City
- Grenada
- State
- Mississippi
- ZIP Code
- 38901-5071
- Phone
- (662) 582-3193
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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