| NPI | 1811711716 |
|---|---|
| Former Name | REBECCA LASHELL UNDERWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-12-30 |