Individual
RODNEY R MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
170 THOMPSON DR, SUITE 103, BRIDGEPORT, WV 26330-2608
(304) 842-6609
Mailing address
PO BOX 271, WORTHINGTON, WV 26591-0271
(304) 657-1656
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
774
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810012357
—
WV
Enumeration date
05/14/2008
Last updated
07/28/2010
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