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PHILLIP RUNYAN

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1063685840

Individual Registrant:
 PHILLIP  RUNYAN 
Gender: M
Sole Proprietor

Location and contact information for practice:
3399 FINCH RD  BISMARCK, AR 71929-7541 US
Tel: 501-865-3363  Fax: --

Contact information for business:
PO BOX 108  BISMARCK, AR 71929-0108 US
Tel: 501-865-3363  Fax: --

Registration Information:
NPI: 1063685840
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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