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General NPI Number Information
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NPI Number | 1265869382
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Entity Type | Individual
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Provider Name | VEEDA L. FOWLER MA, LCPC, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1150 GRAHAM RD STE 101-102
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City | FLORISSANT
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State | MO
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Zip | 63031-8077
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Country | US
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Telephone | 618-567-3815
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Fax |
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Provider Business Mailing Address
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Address Line | 2403 LITTLE ROUND TOP DR
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3131
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180005501
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2001030203
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License Number State | MO
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