| Emily J. Runyan Lcp, Llc | |
|
4601 E Douglas Ave Office 128 Wichita KS 67218-1031 | |
| (316) 337-5530 | |
| Not Available |
| Full Name | Emily J. Runyan Lcp, Llc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 4601 E Douglas Ave, Wichita, Kansas |
| Authorized Official Name and Position | Emily Joy Runyan (PSYCHOTHERAPIST/OWNER) |
| Authorized Official Contact | 3162084700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emily J. Runyan Lcp, Llc 4601 E Douglas Ave Office 128 Wichita KS 67218-1031 Ph: (316) 337-5530 | Emily J. Runyan Lcp, Llc 4601 E Douglas Ave Office 128 Wichita KS 67218-1031 Ph: (316) 337-5530 |
| NPI Number | 1407252851 |
|---|---|
| Provider Enumeration Date | 11/12/2014 |
| Last Update Date | 10/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407252851 | NPI | - | NPPES |
| 200621080B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 1448 (Kansas) | Primary |
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