Provider Demographics
NPI:1699008151
Name:RUNYAN, EMILY J (LMLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:J
Last Name:RUNYAN
Suffix:
Gender:F
Credentials:LMLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:J
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMLP
Mailing Address - Street 1:635 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3602
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-660-7510
Practice Address - Street 1:934 N WATER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3838
Practice Address - Country:US
Practice Address - Phone:316-660-7525
Practice Address - Fax:316-660-7510
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1260103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling