Individual
CONNIE UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC III
Contact information
Practice address
2211 FULTON AVE, CINCINNATI, OH 45206
(513) 961-4663
Mailing address
3819 SIMPSON AVE, CINCINNATI, OH 45227-3642
(513) 304-3467
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII161742
OH
Other
Enumeration date
02/10/2016
Last updated
07/07/2018
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