Individual
WILLIAM OWEN FUNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
4727 MIAMI ST, SOUTH BEND, IN 46614-3225
(574) 231-8480
Mailing address
1441 E 84TH PL, MERRILLVILLE, IN 46410-6578
(219) 769-4005
(219) 794-2010
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012047A
IN
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/02/2023
Last updated
08/09/2024
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