Provider Demographics
NPI:1528419645
Name:ARIZONA INTEGRATED MOBILE WELLNESS
Entity Type:Organization
Organization Name:ARIZONA INTEGRATED MOBILE WELLNESS
Other - Org Name:DR. CYNTHIA DOWDALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOWDALL-THOMAE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-906-1227
Mailing Address - Street 1:633 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7801
Mailing Address - Country:US
Mailing Address - Phone:520-906-1227
Mailing Address - Fax:
Practice Address - Street 1:633 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7801
Practice Address - Country:US
Practice Address - Phone:520-906-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC190251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health