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Individual

LUDELLA MCCULLOUGH-LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
358 E JAVELINA AVE, MESA, AZ 85210-6205
(480) 507-3180
Mailing address
8135 GOODMAN RD, OLIVE BRANCH, MS 38654-2103
(662) 318-5018

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
300564
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
906019
MS

Other

Enumeration date
06/08/2023
Last updated
04/26/2024
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