Provider Information for 1942895826
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Dr. OLIVETT D UNDERWOOD-MOBLEY DSW, LCSW
Other Names:Professional Name:Dr. OLIVETT D UNDERWOOD-MOBLEY DSW, LCSWSex: Female
NPI: 1942895826
Last Updated: 2021-03-03
Certification Date: 2021-03-03
Certification Date: 2021-03-03
Details
| Name | Value | ||||||||||||||
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| NPI | 1942895826 | ||||||||||||||
| Enumeration Date | 2021-03-03 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 158 LITTLE ORANGE LAKE DR HAWTHORNE, FL 32640-6026 United States Phone: 352-448-1944 | Fax: | ||||||||||||||
| Primary Practice Address | 158 LITTLE ORANGE LAKE DR HAWTHORNE, FL 32640-6026 United States Phone: 352-448-1944 | Fax: | ||||||||||||||
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