Individual
TIMOTHY GORDON RUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
16 FIFTH ST, DOVER, NH 03820-2950
(603) 749-4462
(603) 749-2475
Mailing address
16 FIFTH ST, DOVER, NH 03820-2950
(603) 749-4462
(603) 749-2475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1255
NH
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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