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General NPI Number Information
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NPI Number | 1053830083
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Entity Type | Individual
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Provider Name | KASSANDRA ELIZABETH LOWERY PHD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 10291 N MERIDIAN ST STE 310
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City | CARMEL
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State | IN
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Zip | 46290-1083
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Country | US
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Telephone | 176-721-9703
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Fax | 317-672-1971
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Provider Business Mailing Address
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Address Line | 9102 N MERIDIAN ST STE 550
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1899
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Country | US
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Telephone | 614-448-6693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043448B
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License Number State | IN
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