Provider Demographics
NPI:1225465743
Name:LOWERY, GINA MARTIN (LMSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARTIN
Last Name:LOWERY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 MARIANA RD
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-4894
Mailing Address - Country:US
Mailing Address - Phone:830-393-3915
Mailing Address - Fax:830-393-3915
Practice Address - Street 1:1156 MARIANA RD
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-4894
Practice Address - Country:US
Practice Address - Phone:830-393-3915
Practice Address - Fax:830-393-3915
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-29
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55722104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker