Provider Demographics
NPI:1962824334
Name:LOWERY, SHANA
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:LOWERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 KANIS RD
Mailing Address - Street 2:201
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6456
Mailing Address - Country:US
Mailing Address - Phone:501-537-0158
Mailing Address - Fax:501-537-0176
Practice Address - Street 1:9101 KANIS RD
Practice Address - Street 2:201
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6456
Practice Address - Country:US
Practice Address - Phone:501-537-0158
Practice Address - Fax:501-537-0176
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist