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General NPI Number Information
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NPI Number | 1548942287
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Entity Type | Individual
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Provider Name | KRISTINA ANNE FOWLER LPC
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Gender | Female
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2115 E CLAIREMONT AVE STE 2
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4761
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Country | US
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Telephone | 763-210-9966
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Fax | 763-210-6886
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Provider Business Mailing Address
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Address Line | N10863 COUNTY ROAD G
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City | NECEDAH
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State | WI
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Zip | 54646-7959
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Country | US
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Telephone | 920-728-3004
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 7353-226
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11431-125
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11431-125
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License Number State | WI
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