| Fowler Psychological Services Inc | |
|
5353 Gamble Dr Suite 108 St Louis Park MN 55416 | |
| (952) 545-8833 | |
| Not Available |
| Full Name | Fowler Psychological Services Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 5353 Gamble Dr, St Louis Park, Minnesota |
| Authorized Official Name and Position | John Richard Fowler (PRESIDENT) |
| Authorized Official Contact | 9525458833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fowler Psychological Services Inc 5353 Gamble Dr Suite 108 St Louis Park MN 55416 Ph: (952) 545-8833 | Fowler Psychological Services Inc 5353 Gamble Dr Suite 108 St Louis Park MN 55416 Ph: (952) 545-8833 |
| NPI Number | 1235249541 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235249541 | NPI | - | NPPES |
| 14757F0 | Other | MN | BCBS |
| 1581524 | Other | MN | MEDICA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP1765 (Minnesota) | Primary |
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