Individual
MICHAEL ARNOLD MCCOLLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1346 ASHLEY SQ, WINSTON SALEM, NC 27103-2949
(336) 768-8023
(336) 768-2382
Mailing address
1346 ASHLEY SQ, WINSTON SALEM, NC 27103-2949
(336) 768-8023
(336) 768-2382
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
611
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000094
—
NC
Enumeration date
06/16/2006
Last updated
07/08/2007
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