Provider Demographics
NPI:1588720817
Name:LOWE, DENISE (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9836 RUSH CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-9178
Mailing Address - Country:US
Mailing Address - Phone:763-443-9107
Mailing Address - Fax:
Practice Address - Street 1:9836 RUSH CREEK BLVD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-9178
Practice Address - Country:US
Practice Address - Phone:763-443-9107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN73G26DAOtherBLUE CROSS BLUE SHIELD
MN46-00955OtherMEDICA