Provider Demographics
NPI:1306948427
Name:LOWE, MARY ANN (SLP)
Entity type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 COLLEGE AVE
Mailing Address - Street 2:GRIFFIN ROAD CLINIC
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7721
Mailing Address - Country:US
Mailing Address - Phone:954-262-7708
Mailing Address - Fax:954-262-2847
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:GRIFFIN ROAD CLINIC
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7721
Practice Address - Country:US
Practice Address - Phone:954-262-7708
Practice Address - Fax:954-262-2847
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1528235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01085161OtherASHA, CCC-SLP
FLSA1528OtherSTATE OF FL DEPT OF HEALT