Individual
STEPHANIE MCCULLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1006 CREEEKSIDE PLACE, OAKWOOD, GA 30566
(678) 521-5347
Mailing address
1006 CREEEKSIDE PLACE, OAKWOOD, GA 30566
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005446
GA
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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