| Doctor Name: | DR. VIRGINIA TAI RUNKO |
| NPI Number: | 1023317518 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 05054 |
| Business Practice Address: | 6535 N Charles St Suite 550 Towson, MD - 212045826 |
| Business Phone Number: | 4104941662 |
| Business Fax Number: | |
| Mailing Address: | 6535 N Charles St, Suite 550 TOWSON |
| State: | MD |
| Postal Code: | 212045826 |
| Phone Number: | 4104941662 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2011 |
| NPI Last Update Date: | 09/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 05054 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |