Individual
MR. BROCTON FUNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
333 DEXTER TER, TONAWANDA, NY 14150-4747
(716) 961-4050
Mailing address
333 DEXTER TER, TONAWANDA, NY 14150-4747
(716) 961-4050
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
1264947181
NY
Other
Enumeration date
09/22/2018
Last updated
09/22/2018
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