Individual
DR. AIMEE E MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
9881 BROKENLAND PKWY, 105, COLUMBIA, MD 21046-1172
(808) 372-7002
(808) 372-7002
Mailing address
3525 SPLIT RAIL LN, ELLICOTT CITY, MD 21042-3832
(808) 372-7002
(808) 372-7002
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
04720
MD
103TC0700X
Clinical Psychologist
PSY461
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000092858
HMSA
HI
05
—
07140002
—
HI
Enumeration date
10/24/2006
Last updated
09/12/2012
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