Provider Demographics
NPI:1881749232
Name:LOWE, MELISSA (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S SPRING AVE # 3300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-977-8884
Mailing Address - Fax:
Practice Address - Street 1:1225 S. GRAND
Practice Address - Street 2:DOOR 3
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-6310
Practice Address - Country:US
Practice Address - Phone:314-977-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004028840237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2004029905OtherHEARING AID DISPENSER
MO339359705Medicaid
MO2004028840OtherAUDIOLOGY LICENSE