Provider Demographics
NPI:1578563490
Name:LOWKES, KATHERINE J (AUD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:LOWKES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255-9481
Mailing Address - Country:US
Mailing Address - Phone:802-366-8020
Mailing Address - Fax:802-366-8030
Practice Address - Street 1:5420 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-9481
Practice Address - Country:US
Practice Address - Phone:802-366-8020
Practice Address - Fax:802-366-8030
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT145.0116267231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT100-7967Medicaid
VT100-7967Medicaid