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NPI Code Detail

MEDICARE: BRITTNI FOWLER

MEDICARE:   BRITTNI  FOWLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist1471MT

General Provider Information

NPI Number : 1578125662
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTNI FOWLER
Provider Business Mailing Address
First Line : 15 CARNEGIE DR
Second Line :
City : KALISPELL
State : MT
Zip : 59901-2579
Country : US
Telephone Number : 406-799-1366
Fax Number :
Provider Business Practice Location Address
First Line : 38 E WASHINGTON ST STE D
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3975
Country : US
Telephone Number : 406-799-1466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2019
Last Update Date : 11/25/2020

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Directions to “ BRITTNI FOWLER ” Practice Location

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