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Individual

TERRI LOEWENTHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-A

Contact information

Practice address
1 LYONS ST, DEDHAM, MA 02026-5599
(781) 329-1400
(781) 278-5667
Mailing address
PO BOX 9120, DEDHAM, MA 02027-9120
(781) 329-1400
(781) 278-5667

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
129
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5102855
MASS HEALTH
01
63412
CHILDRENS MEDICAL SECURIT
01
AD0067
BS BLUECARE ELECT
Enumeration date
06/28/2005
Last updated
07/08/2007
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