Provider Demographics
NPI:1316361587
Name:LOWERY, JESSICA LORA (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LORA
Last Name:LOWERY
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LORA
Other - Last Name:ANDERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:1717 E. PRIMROSE
Mailing Address - Street 2:APT E212
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804
Mailing Address - Country:US
Mailing Address - Phone:269-967-8014
Mailing Address - Fax:
Practice Address - Street 1:1717 E. PRIMROSE
Practice Address - Street 2:APT E212
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804
Practice Address - Country:US
Practice Address - Phone:269-967-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-09
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional