Individual
CAROL ANN FUNDERBURGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
434 58TH PL, HINSDALE, IL 60521-4982
(630) 464-2447
Mailing address
434 58TH PL, HINSDALE, IL 60521-4982
(630) 464-2447
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-59951
IL
Other
Enumeration date
07/07/2018
Last updated
07/07/2018
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