Individual
JACK UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LPC
Contact information
Practice address
3108 PIEDMONT RD NE, ATLANTA, GA 30305-2513
(404) 421-5341
Mailing address
892 ARLINGTON DR, TUCKER, GA 30084-1567
(404) 421-5341
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC007057
GA
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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