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General NPI Number Information
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NPI Number | 1639025679
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Entity Type | Individual
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Provider Name | AYANNA FOWLER
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Gender | Female
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 10 LANIDEX PLZ W
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City | PARSIPPANY
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State | NJ
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Zip | 07054-2715
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Country | US
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Telephone | 862-356-6059
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 MADISON AVE APT 413
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City | ELIZABETH
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State | NJ
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Zip | 07201-1767
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Country | US
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Telephone | 303-437-2625
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37AC00760800
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License Number State | NJ
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