Provider Demographics
NPI:1104577840
Name:LOWDER, RACHEL DIANE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANE
Last Name:LOWDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 PHILIPSBURG BIGLER HWY
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-8112
Mailing Address - Country:US
Mailing Address - Phone:814-342-5678
Mailing Address - Fax:
Practice Address - Street 1:222 ALLEGHENY BLVD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-2320
Practice Address - Country:US
Practice Address - Phone:814-715-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138849104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker