Provider Demographics
NPI:1386255255
Name:LOWTHER, EMMA YVONNE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:YVONNE
Last Name:LOWTHER
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 1:1255 N 1200 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2445
Mailing Address - Country:US
Mailing Address - Phone:801-229-1181
Mailing Address - Fax:801-373-0639
Practice Address - Street 1:1255 N 1200 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2445
Practice Address - Country:US
Practice Address - Phone:801-229-1181
Practice Address - Fax:801-373-0639
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
UT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program