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NPI Code Detail

MEDICARE: MRS. RAEGAN A LOWDER MS, LPC

MEDICARE:  MRS. RAEGAN A LOWDER  MS, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4033OK

General Provider Information

NPI Number : 1932522034
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RAEGAN A LOWDER MS, LPC
Provider Business Mailing Address
First Line : 3324 NE 135TH ST
Second Line :
City : LAWTON
State : OK
Zip : 73507-5816
Country : US
Telephone Number : 580-591-1758
Fax Number :
Provider Business Practice Location Address
First Line : 601 NW FORT SILL BLVD
Second Line :
City : LAWTON
State : OK
Zip : 73507-6601
Country : US
Telephone Number : 580-355-5170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2014
Last Update Date : 01/24/2014

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