Individual
MRS. ROSETTA UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., ED.S.
Contact information
Practice address
495 PARK AVE, MIDDLEBOURNE, WV 26149-9621
(304) 758-2973
Mailing address
495 PARK AVE, MIDDLEBOURNE, WV 26149-9621
(304) 758-2973
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
610
WV
103TB0200X
Cognitive & Behavioral Psychologist
610
WV
103TS0200X
School Psychologist
21004
WV
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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