Mayo R Funderburg II, LADCA
NPI #1053612192 in Nantucket, Massachusetts
Provider Information
- NPI Number
- 1053612192
- Entity Type
- Individual
- Name
- Mayo R Funderburg II, LADCA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- LADCA
- Enumeration Date
- Nov 5, 2010
- Last Updated
- Nov 5, 2010
Practice Location
- Address
- 20 VESPER LN UNIT L1
- City
- Nantucket
- State
- Massachusetts
- ZIP Code
- 02554-4394
- Phone
- (508) 228-2689
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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