Individual
MRS. JESSICA MAE RUNKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
316 RAILROAD AVE, GOLDSBORO, MD 21636-1126
(410) 634-2380
(833) 908-2287
Mailing address
316 RAILROAD AVE, GOLDSBORO, MD 21636-1126
(410) 634-2380
(833) 908-2287
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC10729
MD
101YP2500X
Professional Counselor
LC10729
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609550002
—
MD
05
—
609550005
—
MD
01
—
LC10729
PROFESSIONAL CLINICAL MENTAL HEALTH COUNSELOR
MD
Enumeration date
04/07/2017
Last updated
11/28/2023
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