Individual
ROBERT ALLEN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
220 ABRAHAM FLEXNER WAY, 6TH FLOOR PSYCHOLOGY DEPARTMENT, LOUISVILLE, KY 40202-3826
(502) 582-7484
(502) 582-7646
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 582-7484
(502) 582-7646
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
130491
KY
103TC2200X
Clinical Child & Adolescent Psychologist
1330
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300001079-KOHMG
—
IN
05
—
7100438340 (KOHMG)
—
KY
05
—
890006900
—
KY
Enumeration date
08/18/2005
Last updated
04/17/2018
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