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Individual

TANESHA S UNDERWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, CCM, LMBT

Contact information

Practice address
1018 BRAMBLEGATE RD, HOPE MILLS, NC 28348-5733
(910) 583-7321
Mailing address
1018 BRAMBLEGATE RD, HOPE MILLS, NC 28348-5733
(910) 583-7321

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
233074
NC
171M00000X
Case Manager/Care Coordinator
4250206
NC
225700000X
Massage Therapist
Primary
18343
NC

Other

Enumeration date
06/13/2021
Last updated
06/13/2021
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