# SOULISTIC MEDICAL INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215986104
- **Authorized official:** MARAYEH CUNNINGHAM PH.D. (MANAGING DIRECTOR)
- **Authorized official phone:** (520) 398-3970

## Contact information

- **Practice address:** 26 TUBAC ROAD, SUITE B, TUBAC, AZ 85646
- **Practice address phone:** (520) 398-3970
- **Practice address fax:** (520) 398-2944
- **Mailing address:** PO BOX 1990, TUBAC, AZ 85646-1990
- **Mailing address phone:** (520) 398-3970
- **Mailing address fax:** (520) 398-2944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 3784 | AZ | — |
| 207Q00000X | Family Medicine Physician | 27940 | AZ | Yes |

## Other

- **Enumeration date:** 05/08/2006
- **Last updated:** 11/29/2011