Individual
MR. JAMES E. FUNDARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
4500 WILDFLOWER DR, FARMINGTON, NM 87401-2825
(505) 325-2008
Mailing address
2905 YALE DR, FARMINGTON, NM 87402-4548
(505) 793-2917
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0101791
NM
Other
Enumeration date
08/20/2008
Last updated
08/21/2008
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