Provider Demographics
NPI:1902631211
Name:O'DOWD, MARY M
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:O'DOWD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:
Other - Last Name:ROLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:679 S REED CT APT 6-405
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4481
Mailing Address - Country:US
Mailing Address - Phone:720-427-1489
Mailing Address - Fax:
Practice Address - Street 1:679 S REED CT APT 6-405
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4481
Practice Address - Country:US
Practice Address - Phone:720-427-1489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician