=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144637588
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANNA ELIZABETH LOWE I BCBA, LBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2014
-----------------------------------------------------
Last Update Date | 01/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19550 N. 10 ST BRENNAN BEHAVIOR GROUP UNIT 1
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-833-6730
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 SWIFT FOX RUN
-----------------------------------------------------
City | MADISONVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-955-2662
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | L-346
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------