Individual
AMY RUNCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4357 13TH AVE S STE 211, FARGO, ND 58103-7506
(701) 248-5300
Mailing address
4357 13TH AVE S STE 211, FARGO, ND 58103-7506
(701) 248-5300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
977-9-15-18
ND
Other
Enumeration date
11/03/2021
Last updated
03/07/2022
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