Misty Dawn Fowler | Farmington, MO • PECOS Search

Misty Dawn Fowler

Social Worker

Behavioral Health & Social Service Providers

1085 Maple St, Farmington, MO 63640-1955

(573) 366-4659 (314) 206-3700

PECOS Enrollment

Based on the most recent information from CMS, provider Misty Dawn Fowler does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:13 AM.

Profile Details

Provider ID
1053095554
Provider Type
Individual
Full Name
Fowler, Misty Dawn
Gender
Female

Sole Proprietor
No
Enumeration Date
6/14/2023
Last Updated
6/14/2023

Contact Information

Practice Location

1085 Maple St, Farmington, MO 63640-1955

Unlisted Fax

Mailing Location

1430 Olive St Ste 400, Saint Louis, MO 63103-2303

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer