Individual
ETHEL LEE UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
3995 VALLEY RD APT 2, CLEVELAND, OH 44109-3040
(216) 778-0959
Mailing address
3995 VALLEY RD APT 2, CLEVELAND, OH 44109-3040
(216) 778-0959
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400782390708
OH
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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