Fowler, Latisha M

Fowler, Latisha M is an individual health care provider with primary practice located at 68 W Church St Ste 318 , Newark OH 43055-5050. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Fowler, Latisha M can be contacted via phone (740) 281-1777.

Contact Information

Primary practice address
68 W Church St Ste 318 Newark OH 43055-5050
Phone: (740) 281-1777
Fax: (740) 281-1778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1275850760
LBN Legal business name Fowler, Latisha M
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2010
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275850760 NPPES
Ohio MEDICAID 0211419

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