Provider Demographics
NPI:1417331877
Name:LOWE, BOBBI JO
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JO
Last Name:LOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6199 MILLER RD
Mailing Address - Street 2:STE A
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-1585
Mailing Address - Country:US
Mailing Address - Phone:810-513-8264
Mailing Address - Fax:517-323-9531
Practice Address - Street 1:6199 MILLER RD
Practice Address - Street 2:STE A
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1585
Practice Address - Country:US
Practice Address - Phone:810-513-8264
Practice Address - Fax:517-323-9531
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional