Provider Demographics
NPI:1497809651
Name:RUNYAN, RICHARD DUANE JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DUANE
Last Name:RUNYAN
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MOUNTAIN ST STE 3H
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3812
Mailing Address - Country:US
Mailing Address - Phone:775-445-7756
Mailing Address - Fax:775-841-0304
Practice Address - Street 1:1001 MOUNTAIN ST STE 3H
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3812
Practice Address - Country:US
Practice Address - Phone:775-445-7756
Practice Address - Fax:775-841-0304
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0386103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical