Provider Demographics
NPI:1093550790
Name:FOWKE, MARGARET LYNN (RD, LD, EMT, CPHT)
Entity type:Individual
Prefix:PROF
First Name:MARGARET
Middle Name:LYNN
Last Name:FOWKE
Suffix:
Gender:F
Credentials:RD, LD, EMT, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E WEST HWY APT 1001
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6277
Mailing Address - Country:US
Mailing Address - Phone:240-460-9715
Mailing Address - Fax:
Practice Address - Street 1:FLOURISH COUNSELING AND WELLNESS CENTER, LLC
Practice Address - Street 2:913 OLNEY SANDY SPRING ROAD
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860
Practice Address - Country:US
Practice Address - Phone:301-570-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0203409146N00000X
MDT25737183700000X
MDD02143133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No183700000XPharmacy Service ProvidersPharmacy Technician