Mikaela Noel Aldaco-Fowler, MA, LMFTA
Individual provider Active NPI Family Psychologist · Kenmore, WA
NPI 1023724853 · NPPES record last updated Jan 25, 2023
Key facts
- NPI
- 1023724853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Psychologist 103TF0000X
- License
- MG61392718 (WA)
- Practice address
- 6532 NE 196TH PL
Kenmore, WA 98028-8653 - Phone
- (425) 866-0548
- NPI assigned
- Jan 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MG61392718 | WA | MD | Family Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Psychologist | 103TF0000X | MG61392718 | WA | Yes |
Addresses
Primary practice location
6532 NE 196TH PL
Kenmore, WA 98028-8653
Mailing address
6532 NE 196TH PL
Kenmore, WA 98028-8653
Phone (425) 866-0548
Other names
- Mikaela Noel Fowler
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- Anthony Paul Amos
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All providers in Kenmore, WA · Family Psychologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.