Individual
KELLIE LYN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
401 NORTHSHORE BLVD, PORTLAND, TX 78374-3800
(361) 643-3777
(361) 643-3777
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(800) 944-9782
(610) 438-2024
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105302
TX
Other
Enumeration date
09/05/2008
Last updated
09/05/2008
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