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NPI Code Detail

MEDICARE: MRS. CHRISTINA ALYCE RUNNELS MA, LPC

MEDICARE: MRS. CHRISTINA ALYCE RUNNELS MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor68799TX

General Provider Information

NPI Number : 1922430263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA ALYCE RUNNELS MA, LPC
Provider Business Mailing Address
First Line : 25527 MYRTLE SPGS
Second Line :
City : SPRING
State : TX
Zip : 77373-8109
Country : US
Telephone Number : 281-635-0998
Fax Number :
Provider Business Practice Location Address
First Line : 1319 LIVE OAK ST
Second Line :
City : HOUSTON
State : TX
Zip : 77003-4408
Country : US
Telephone Number : 281-635-0998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2013
Last Update Date : 01/22/2014

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