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Individual

DR. CHARLES K. UNDERWOOD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D. LMHC

Contact information

Practice address
1047 SHINNECOCK HILLS DR, OVIEDO, FL 32765-5809
(407) 342-7165
(407) 977-0931
Mailing address
PO BOX 825, GOLDENROD, FL 32733-0825
(407) 342-7165
(407) 977-0931

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH 6777
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Z024Y
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/22/2008
Last updated
10/22/2008
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