Individual
MIRA FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4842 SW ASTER ST, CORVALLIS, OR 97333-1364
(541) 224-8210
Mailing address
4842 SW ASTER ST, CORVALLIS, OR 97333-1364
(617) 852-8749
(541) 257-5485
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/28/2016
Last updated
02/23/2024
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