Provider Demographics
NPI:1801025101
Name:MICKEL LOWENSTEIN, CARLOTTA (MA, SLP)
Entity Type:Individual
Prefix:
First Name:CARLOTTA
Middle Name:
Last Name:MICKEL LOWENSTEIN
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:CARLOTTA
Other - Middle Name:MICKEL
Other - Last Name:LOWENSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, SLP
Mailing Address - Street 1:2641 LITTLE BEND PL
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-4161
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7201 GREENBORO DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1698
Practice Address - Country:US
Practice Address - Phone:321-727-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist