Individual
MRS. DYNATA CHARLES FUNDERBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
806 MAPLE RD, FLOSSMOOR, IL 60422-1060
(708) 647-6426
(708) 647-6233
Mailing address
806 MAPLE RD, FLOSSMOOR, IL 60422-1060
(708) 647-6426
(708) 647-6233
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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