Provider Demographics
NPI:1366995532
Name:LOWRY, ELIZABETH (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 LAKELAND TER
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4702
Mailing Address - Country:US
Mailing Address - Phone:601-401-0422
Mailing Address - Fax:
Practice Address - Street 1:2510 LAKELAND TER
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4702
Practice Address - Country:US
Practice Address - Phone:601-401-0422
Practice Address - Fax:601-653-0050
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS190081103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst