Individual
BRENT FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1 FORD PL, 1E, DETROIT, MI 48202-3450
(313) 874-6651
Mailing address
1 FORD PL, 1E, DETROIT, MI 48202-3450
(313) 874-6651
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
6301014872
MI
103TC0700X
Clinical Psychologist
Primary
6301014872
MI
Other
Enumeration date
01/18/2013
Last updated
12/01/2023
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