Individual
STARLYNN EVANGELINE UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3494 LIBERTY RD S, SALEM, OR 97302-4607
(971) 304-0660
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
A569226
OR
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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