Individual
KAREN M. UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
111 FAYETTE AVE, FAYETTEVILLE, WV 25840-1219
(304) 574-1176
Mailing address
PO BOX 324, HILLTOP, WV 25855-0324
(304) 465-8998
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0689
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012397000
—
WV
Enumeration date
10/18/2007
Last updated
10/18/2007
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