Malisa Funderburk

NPI #1407589211 in Buford, Georgia

Provider Information

NPI Number: 1407589211
Entity Type: Individual
Name: Malisa Funderburk
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Jul 8, 2022
Last Updated: Jul 8, 2022

Practice Location

Address: 4330 S LEE ST STE 600
City: Buford
State: Georgia
ZIP Code: 30518-5795
Phone: (770) 648-2500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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