Provider Demographics
NPI:1629197850
Name:LOWDER, MILT (PHD)
Entity type:Individual
Prefix:DR
First Name:MILT
Middle Name:
Last Name:LOWDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E WASHINGTON ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3054
Mailing Address - Country:US
Mailing Address - Phone:864-239-4110
Mailing Address - Fax:
Practice Address - Street 1:800 E WASHINGTON ST
Practice Address - Street 2:SUITE G
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3054
Practice Address - Country:US
Practice Address - Phone:864-239-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1029103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling