Individual
JEAN A FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW LSW
Contact information
Practice address
188 W HEBBLE AVE, FAIRBORN, OH 45324-4960
(937) 791-1440
Mailing address
PO BOX 396, SPRINGBORO, OH 45066-0396
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S0028716
OH
Other
Enumeration date
05/03/2007
Last updated
03/01/2022
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