Healthcare Provider Details

I. General information

NPI: 1417207325
Provider Name (Legal Business Name): RACHEL ANN LOWRY SPEECH THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 EAST SPRUCE STREET
EAST ROCHESTER NY
14445
US

IV. Provider business mailing address

231 E SPRUCE ST
EAST ROCHESTER NY
14445-1531
US

V. Phone/Fax

Practice location:
  • Phone: 716-378-4280
  • Fax:
Mailing address:
  • Phone: 716-378-4280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2286454
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: