Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-08-4552 | AL |
NPI | 1003044959 |
---|---|
Provider Name | Mrs. Jennifer Sonmor Underwood |
First Address | Montgomery, AL 36116-1396 |
Second Address | Montgomery, AL 36116-1396 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 30/06/2009 |