Individual
JOHN PERRY FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
410 N ARMIJO ST, APT. 2, LAS CRUCES, NM 88005-2582
(505) 650-1111
Mailing address
410 N ARMIJO ST, APT. 2, LAS CRUCES, NM 88005-2582
(505) 650-1111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-058184
NM
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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