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General NPI Number Information
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NPI Number | 1366072308
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Entity Type | Individual
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Provider Name | DIOR LOWRY CSW, BA, CES, BCS
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Gender | Male
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 200 W 1ST ST
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City | ROSWELL
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State | NM
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Zip | 88203-4668
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Country | US
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Telephone | 484-942-9901
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W 1ST ST STE 442
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City | ROSWELL
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State | NM
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Zip | 88203-4675
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Country | US
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Telephone | 484-942-9901
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 226000000X
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Taxonomy Name | Recreational Therapist Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NM
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