Individual
SHERESE TWYANA MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2419 OLD THOMPSON BRIDGE RD APT J5, GAINESVILLE, GA 30501-1167
(678) 858-3322
Mailing address
2419 OLD THOMPSON BRIDGE RD APT J5, GAINESVILLE, GA 30501-1167
(678) 858-3322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
106E00000X
Assistant Behavior Analyst
—
—
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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