Individual
EBONY AYANA UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 MEMORIAL CIR, CLARKSVILLE, TN 37043-4539
(931) 920-7333
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 912-1640
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/21/2014
Last updated
01/11/2019
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