Provider Demographics
NPI:1679346589
Name:LOWE, MARIAH (RCISW, MSW)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:RCISW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PLANTATION CLUB DR APT 1315
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1972
Mailing Address - Country:US
Mailing Address - Phone:321-482-2250
Mailing Address - Fax:
Practice Address - Street 1:2955 PINEDA PLAZA WAY # 209210
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7318
Practice Address - Country:US
Practice Address - Phone:321-610-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW159331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical