Provider Demographics
NPI:1528413267
Name:LOWRY, EDITH AMY (LPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:AMY
Last Name:LOWRY
Suffix:
Gender:F
Credentials:LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-5017
Mailing Address - Country:US
Mailing Address - Phone:580-924-4779
Mailing Address - Fax:
Practice Address - Street 1:114 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-5017
Practice Address - Country:US
Practice Address - Phone:580-924-4779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor