Provider Demographics
NPI:1083372130
Name:LOWDER, ALICIA WILLIAMS (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:WILLIAMS
Last Name:LOWDER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25619 AUSTIN RD
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-8383
Mailing Address - Country:US
Mailing Address - Phone:704-550-7111
Mailing Address - Fax:
Practice Address - Street 1:33426 OLD SALISBURY RD
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-8342
Practice Address - Country:US
Practice Address - Phone:704-983-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3891224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant