Provider Demographics
NPI:1992439384
Name:LOWRY, VERONICA
Entity type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:
Last Name:LOWRY
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 1:2575 REVOLUTION ST UNIT 103
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3853
Mailing Address - Country:US
Mailing Address - Phone:434-806-8155
Mailing Address - Fax:
Practice Address - Street 1:3790 DAIRY RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-7630
Practice Address - Country:US
Practice Address - Phone:321-729-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician