Individual
DR. JANETTE LYNN FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1577 SOUTH AVE, ROCHESTER, NY 14620-3914
(413) 884-4341
Mailing address
26 AVONMORE WAY, PENFIELD, NY 14526-1624
(413) 884-4341
(585) 273-1117
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
018667-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12130018
CAQH
NY
Enumeration date
07/22/2010
Last updated
07/22/2010
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