Healthcare Provider Details

I. General information

NPI: 1932313848
Provider Name (Legal Business Name): RHONDA JEANNE LOWRY-MCENTIRE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. RHONDA JEANNE LOWRY-MCENTIRE

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 LAKEVIEW WAY
INTERLACHEN FL
32148
US

IV. Provider business mailing address

130 LAKEVIEW WAY
INTERLACHEN FL
32148
US

V. Phone/Fax

Practice location:
  • Phone: 386-218-8493
  • Fax:
Mailing address:
  • Phone: 386-218-8493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 8610
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: