Individual
KISSA UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1900 WYOMING AVE, SUITE B, EL PASO, TX 79903-3409
(915) 779-4527
(915) 779-3511
Mailing address
1900 WYOMING AVE, SUITE B, EL PASO, TX 79903-3409
(915) 779-4527
(915) 779-3511
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDC 12944
TX
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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