Provider Demographics
NPI:1497394282
Name:LOWE-GIBSON, RUTH VIRGINIA
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:VIRGINIA
Last Name:LOWE-GIBSON
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 1:4497 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6947
Mailing Address - Country:US
Mailing Address - Phone:216-609-6328
Mailing Address - Fax:
Practice Address - Street 1:4497 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-6947
Practice Address - Country:US
Practice Address - Phone:216-609-6328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator