Provider Demographics
NPI:1619752847
Name:LOWENTHAL, CECILIA LAETITIA (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:LAETITIA
Last Name:LOWENTHAL
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5820
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40255-0820
Mailing Address - Country:US
Mailing Address - Phone:626-201-0267
Mailing Address - Fax:
Practice Address - Street 1:1703 ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1329
Practice Address - Country:US
Practice Address - Phone:626-201-0267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist