Provider Information for 1972935757
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TIMOTHY R UNDERWOOD Psy.D
Sex: Male
NPI: 1972935757
Last Updated: 2024-02-20
Certification Date: 2024-02-20
Certification Date: 2024-02-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1972935757 | ||||||||
| Enumeration Date | 2013-08-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4700 LAS VEGAS BLVD N NELLIS AFB, NV 89191-6600 United States Phone: 702-653-2273 | Fax: | ||||||||
| Primary Practice Address | 4700 LAS VEGAS BLVD N NELLIS AFB, NV 89191-6600 United States Phone: 702-653-2273 | Fax: | ||||||||
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