Individual
KELLY A UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
73 N MAIN ST STE 109, GLOVERSVILLE, NY 12078-3043
(518) 527-1676
(518) 527-1676
Mailing address
73 N MAIN ST STE 109, GLOVERSVILLE, NY 12078-3043
(518) 527-1676
(518) 448-5879
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32760
NY
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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