Doctor Name: | DONALD L RUNNELS |
NPI Number: | 1891031456 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 115 E 2nd St Watonga, OK - 737723801 |
Business Phone Number: | 4025418974 |
Business Fax Number: | |
Mailing Address: | 115 E 2nd St, WATONGA |
State: | OK |
Postal Code: | 737723801 |
Phone Number: | 4025418974 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2012 |
NPI Last Update Date: | 12/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |