Funk, Jeanne Brockmyer
Funk, Jeanne Brockmyer is an individual health care provider with primary practice located at 2801 West Bancroft Ms 948, Toledo OH 43606-3390. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Funk, Jeanne Brockmyer can be contacted via phone (419) 530-4392.Contact Information
Primary practice address
2801 West Bancroft Ms 948
Toledo OH 43606-3390
Phone: (419) 530-4392
Fax: (419) 530-4392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2732 | Ohio |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 2732 | Ohio |
Profile Details
| NPI number | 1588604847 |
|---|---|
| LBN Legal business name | Funk, Jeanne Brockmyer |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588604847 | NPPES |
| Ohio | MEDICAID | 0394747 |
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