Provider Information for 1619149390
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Mrs. MARY CATHERINE RUNYAN RN, LPCC
Sex: Female
NPI: 1619149390
Last Updated: 2008-04-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1619149390 | ||||||||||||
| Enumeration Date | 2008-04-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4576 BERGER RD GROVEPORT, OH 43125-9259 United States Phone: 614-830-1156 | Fax: | ||||||||||||
| Primary Practice Address | 588 E RICH ST COLUMBUS, OH 43215-5335 United States Phone: 614-228-7820 | Fax: | ||||||||||||
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