Fowler, Jessica

Fowler, Jessica is an individual health care provider with primary practice located at 807 E Washington St , Medina OH 44256-3338. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Fowler, Jessica can be contacted via phone (330) 241-4444.

Contact Information

Primary practice address
807 E Washington St Medina OH 44256-3338
Phone: (330) 241-4444
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X F.1800035-SUPV Ohio
Behavioral Health & Social Service Providers / Mental Health 101YM0800X E.1800520-SUPV Ohio

Profile Details

NPI number 1134663313
LBN Legal business name Fowler, Jessica
Credentials IMFT-S, LPCC-S
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2016
Last updated Jan 23rd, 2020 - about 6 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 1134663313 NPPES
Ohio MEDICAID 0260282

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