Healthcare Provider Details

I. General information

NPI: 1437829660
Provider Name (Legal Business Name): VICTORIA ALEXIS LOWTHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2021
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CROSS STREET
AKRON OH
44311-1026
US

IV. Provider business mailing address

150 CROSS STREET
AKRON OH
44311-1026
US

V. Phone/Fax

Practice location:
  • Phone: 330-996-9141
  • Fax:
Mailing address:
  • Phone: 330-996-9141
  • Fax: 330-678-3677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberC.2204114-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: