Provider Demographics
NPI:1871848135
Name:LOWRY, CHARLY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHARLY
Middle Name:
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:CHARLY
Other - Middle Name:
Other - Last Name:BENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 WINTERBERRY CV
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3367
Mailing Address - Country:US
Mailing Address - Phone:210-540-0672
Mailing Address - Fax:
Practice Address - Street 1:300 WINTERBERRY CV
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-3367
Practice Address - Country:US
Practice Address - Phone:210-540-0672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist