Most Relevant Information
Provider Data
| NPI Number: | 1003588062 |
| Provider Name: | AYREL J FUNDERBURK |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/29/2021 |
| Last Updated: | 09/29/2021 |
Provider Practice Location
118 AZALEA CT
UPPER MARLBORO
MD
207741671
Practice Location Phone/Fax
| Phone: | 8568894278 |
| Fax: |
Provider Mailing Location
118 AZALEA CT
UPPER MARLBORO
MD
207741671
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |