Individual
MS. JANIS MCCULLOUGH
Active
Individual
MS. JANIS MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, OT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009666
WA
225X00000X
Occupational Therapist
OT00004049
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8439648
—
WA
Enumeration date
02/12/2007
Last updated
05/16/2014
Update your record
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