Individual provider · Type 1 NPI
Theodore William Fowler
Addiction (Substance Use Disorder) Counselor · San Jose, CA
NPI number
1487162962
Active
Practice location
650 S Bascom Ave
San Jose, CA 95128-2601
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | R1208500715 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1487162962
Theodore William Fowler's National Provider Identifier is 1487162962, issued on Jan 18, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Jose, CA. The record was last updated on Jan 18, 2018.