Provider Demographics
NPI:1124334958
Name:LOWE, GENNA EVE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:GENNA
Middle Name:EVE
Last Name:LOWE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:GENNA
Other - Middle Name:EVE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7208 W MORROW DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5845
Mailing Address - Country:US
Mailing Address - Phone:602-616-2227
Mailing Address - Fax:
Practice Address - Street 1:21630 N 19TH AVE STE B3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2717
Practice Address - Country:US
Practice Address - Phone:602-726-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP6948235Z00000X
AZSLP6948235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist