Provider Demographics
NPI:1164670097
Name:LOWRY, KATHERINE A (MSED)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:A
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 DEL PRADO BLVD S STE 410
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5709
Mailing Address - Country:US
Mailing Address - Phone:239-443-6385
Mailing Address - Fax:239-242-6389
Practice Address - Street 1:2503 DEL PRADO BLVD S STE 410
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5709
Practice Address - Country:US
Practice Address - Phone:239-443-6385
Practice Address - Fax:239-242-6389
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYE.1100007101YM0800X
FLMH 9570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health