Individual provider · Type 1 NPI
Dynata Charles Funderburg, M.A.
Intellectual & Developmental Disabilities Psychologist · Flossmoor, IL
NPI number
1548486152
Active
Practice location
806 Maple Rd
Flossmoor, IL 60422-1060
Fax (708) 647-6233
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual & Developmental Disabilities Psychologist Primary | 103TM1800X | None listed |
Intellectual & Developmental Disabilities Psychologist: Definition to come...
About NPI 1548486152
Dynata Charles Funderburg, M.A.'s National Provider Identifier is 1548486152, issued on Apr 18, 2007. The primary taxonomy on file is Intellectual & Developmental Disabilities Psychologist (103TM1800X), and the practice location is in Flossmoor, IL. The record was last updated on Jul 8, 2007.