Individual
JORDAN RAE RUNCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7413 SQUIRE CT, WEST CHESTER, OH 45069-2380
(513) 847-4685
Mailing address
PO BOX 255, ADDYSTON, OH 45001-0255
(513) 470-1449
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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