Individual
TAWNY NICOLE WHITE RUNNELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LPC, NCC
Contact information
Practice address
6635 W HAPPY VALLEY RD STE A104-148, GLENDALE, AZ 85310-2609
(623) 680-3469
Mailing address
6635 W HAPPY VALLEY RD STE A104-148, GLENDALE, AZ 85310-2609
(623) 680-3469
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LAC-16364
AZ
101YP2500X
Professional Counselor
Primary
LPC-18204
AZ
Other
Enumeration date
05/27/2019
Last updated
03/03/2020
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