Individual
REGINA UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, RPT
Contact information
Practice address
6202 S LEWIS AVE STE A, TULSA, OK 74136-1064
(918) 949-4515
(918) 949-4515
Mailing address
8637 SOUTH 73RD EAST AVENUE, TULSA, OK 74133
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5521
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200388740B
—
OK
Enumeration date
03/29/2011
Last updated
03/17/2018
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