| Fowler Psychological Services, Inc. | |
|
5353 Gamble Dr 108 St Louis Park MN 55416-1509 | |
| (952) 545-8833 | |
| (952) 224-2299 |
| Full Name | Fowler Psychological Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| 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 108 St Louis Park MN 55416-1509 Ph: (952) 545-8833 | Fowler Psychological Services, Inc. 5353 Gamble Dr 108 St Louis Park MN 55416-1509 Ph: (952) 545-8833 |
| NPI Number | 1477709392 |
|---|---|
| Provider Enumeration Date | 08/12/2008 |
| Last Update Date | 08/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477709392 | NPI | - | NPPES |
| 620000219 | Other | MN | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP1765 (Minnesota) | Primary |
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