Provider Demographics
NPI:1508168683
Name:DOWDY RODGERS, GWENDOLYN LORRAINE (BS,MM,MHRM)
Entity Type:Individual
Prefix:MRS
First Name:GWENDOLYN
Middle Name:LORRAINE
Last Name:DOWDY RODGERS
Suffix:
Gender:F
Credentials:BS,MM,MHRM
Other - Prefix:
Other - First Name:GWENDOLYN
Other - Middle Name:LORRAINE
Other - Last Name:DOWDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5941 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-0216
Mailing Address - Country:US
Mailing Address - Phone:909-880-0352
Mailing Address - Fax:
Practice Address - Street 1:572 N ARROWHEAD AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1212
Practice Address - Country:US
Practice Address - Phone:909-266-2705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator