Provider Demographics
NPI:1689875502
Name:FOWLER, LEIGH (MS)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 CATHWICK DR
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-3478
Mailing Address - Country:US
Mailing Address - Phone:205-917-2942
Mailing Address - Fax:205-917-2980
Practice Address - Street 1:600 BEACON PKWY W STE 800
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3113
Practice Address - Country:US
Practice Address - Phone:205-917-2942
Practice Address - Fax:205-917-2980
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor