Provider Demographics
NPI:1871727495
Name:FOWLER, KAREN DENICE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DENICE
Last Name:FOWLER
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W 5TH AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4056
Mailing Address - Country:US
Mailing Address - Phone:405-743-1968
Mailing Address - Fax:
Practice Address - Street 1:217 W 5TH AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4056
Practice Address - Country:US
Practice Address - Phone:405-743-1968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional