Provider Demographics
NPI:1801153796
Name:LOWRY, SUZANNE (CMHC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:LOWRY
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E 4800 S STE 120C
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5557
Mailing Address - Country:US
Mailing Address - Phone:801-899-6797
Mailing Address - Fax:801-446-3999
Practice Address - Street 1:825 E 4800 S STE 120C
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5557
Practice Address - Country:US
Practice Address - Phone:801-899-6797
Practice Address - Fax:801-446-3999
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2018-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8597001-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional