Individual
JOHNNIE UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
101 YACHT CT, WILLIAMSBURG, VA 23185-5368
(757) 660-1074
Mailing address
101 YACHT CT, WILLIAMSBURG, VA 23185-5368
(757) 660-1074
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000836
VA
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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