Individual
GINA UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
T21101
Contact information
Practice address
1221 PIERCE ST, SIOUX CITY, IA 51105-1418
(712) 255-0204
Mailing address
1221 PIERCE ST, SIOUX CITY, IA 51105-1418
(712) 255-0204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T21101
IA
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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