Provider Demographics
NPI:1831467216
Name:RUNION, KELLY E (MS)
Entity Type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:E
Last Name:RUNION
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:51 SOUTHLAND DR
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-2244
Mailing Address - Country:US
Mailing Address - Phone:304-363-3167
Mailing Address - Fax:304-363-1725
Practice Address - Street 1:51 SOUTHLAND DR
Practice Address - Street 2:SUITE 2300
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2244
Practice Address - Country:US
Practice Address - Phone:304-363-3167
Practice Address - Fax:304-363-1725
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist