Individual
JACQUELINE BAYS RUNYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 MEDICAL CENTER BLVD, SUITE 290, LAWRENCEVILLE, GA 30046-8708
(770) 962-5100
(770) 962-7006
Mailing address
500 MEDICAL CENTER BLVD, SUITE 290, LAWRENCEVILLE, GA 30046-8708
(770) 962-5100
(770) 962-7006
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0555526
GA
Other
Enumeration date
04/05/2012
Last updated
04/05/2012
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