person
Mayo R Funderburg II, LADCA
Addiction (Substance Use Disorder) Counselor in Nantucket, Massachusetts
NPI 1053612192

Mayo R Funderburg II is an Addiction (Substance Use Disorder) Counselor based in Nantucket, MA and is specialized in Addiction (Substance Use Disorder). Mayo R Funderburg II practices in Nantucket, MA and has the professional credentials of LADCA. The NPI Number for Mayo R Funderburg II is 1053612192 and holds a License No. 2282 (Massachusetts).

The current practice location address for Mayo R Funderburg II is 20 Vesper Ln Unit L1, Nantucket, MA and can be reached out via phone at 508-228-2689 and via fax at 508-228-3613. You can also correspond with Mayo R Funderburg II through the mailing address at 20 VESPER LN UNIT L1, NANTUCKET, MA - 02554-4394 (mailing address contact number: 508-228-2689).

Location: 20 Vesper Ln Unit L1, Nantucket, MA, 02554-4394
person
Provider Profile Details
NPI Number
1053612192
Provider Name
Mayo R Funderburg II
Credential
LADCA
Provider Entity Type
Individual
Gender
Male
Address
20 Vesper Ln Unit L1, Nantucket, MA, 02554-4394
Phone Number
508-228-2689
Fax Number
508-228-3613
Provider Enumeration Date
11/05/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
20 Vesper Ln Unit L1
City
State
Zip
02554-4394
Phone Number
508-228-2689
Fax Number
508-228-3613
person
Provider Business Mailing Address Details
Address
20 Vesper Ln Unit L1
City
State
Zip
02554-4394
Phone Number
508-228-2689
Fax Number
508-228-3613
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
2282 (Massachusetts)
Definition
Definition to come...
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