Individual
MRS. CAROL A UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., SLP
Contact information
Practice address
149 DAYTON AVE, MANORVILLE, NY 11949-2005
(631) 878-4441
Mailing address
149 DAYTON AVE, MANORVILLE, NY 11949-2005
(631) 878-4441
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02558794
—
NY
Enumeration date
10/02/2010
Last updated
10/02/2010
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