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General NPI Number Information
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NPI Number | 1194538835
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Entity Type | Individual
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Provider Name | EMILY MARIE FOWLER MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 18946 N DALE MABRY HWY
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City | LUTZ
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State | FL
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Zip | 33548-4900
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Country | US
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Telephone | 813-388-1263
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Fax | 888-305-0189
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Provider Business Mailing Address
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Address Line | 6207 S WEST SHORE BLVD APT 5021
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City | TAMPA
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State | FL
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Zip | 33616-1667
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA22824
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License Number State | FL
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