Individual
DR. ELLEN LOWERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LP
Contact information
Practice address
7600 BOONE AVE N, SUITE 2, BROOKLYN PARK, MN 55428-4563
(763) 515-2450
Mailing address
7600 BOONE AVE N, SUITE 2, BROOKLYN PARK, MN 55428-4563
(763) 515-2450
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00091
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012053
P1
MN
01
—
114927
UC
MN
01
—
148951
CP
MN
01
—
21266
HP
MN
01
—
26D11LO
BCBS
MN
05
—
512716500
—
MN
01
—
61-52204
UBH
MN
Enumeration date
07/27/2006
Last updated
07/18/2014
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