Individual
MS. MARYANNA MAY MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1310 6TH ST APT 301, BROOKINGS, SD 57006-2383
(605) 630-6732
Mailing address
1310 6TH ST APT 301, BROOKINGS, SD 57006-2383
(605) 630-6732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002230
VA
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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