| NPI | 1952655383 |
|---|---|
| Former Name | STEPHANIE ANN UNDERWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.1200260-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH C-1200260-TRNE) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2021-10-14 |