MAYO R FUNDERBURG

NANTUCKET, MA
NPI1053612192
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MA  2282)
Enumeration Date2010-11-05
Last Update Date2010-11-05
Business Address
-- MAYO R FUNDERBURG LADCA
20 VESPER LN UNIT L1
NANTUCKET, MA 02554-4394
Phone number: 508-228-2689
Mailing Address
-- MAYO R FUNDERBURG LADCA
20 VESPER LN UNIT L1
NANTUCKET, MA 02554-4394
Phone number: 508-228-2689
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