Provider Demographics
NPI:1003044959
Name:UNDERWOOD, JENNIFER SONMOR (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SONMOR
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6980 VAUGHN POINTE DR APT H
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1396
Mailing Address - Country:US
Mailing Address - Phone:334-790-7460
Mailing Address - Fax:334-899-4333
Practice Address - Street 1:6980 VAUGHN POINTE DR APT H
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-1396
Practice Address - Country:US
Practice Address - Phone:334-790-7460
Practice Address - Fax:334-899-4333
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-08-4552103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst