Individual
TIFFANY VILESE MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
5200 PARK RD STE 218B, CHARLOTTE, NC 28209-3650
(866) 700-1606
(866) 338-5921
Mailing address
2365 SHARON RD APT 2, CHARLOTTE, NC 28211-1653
(678) 471-5302
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
12099A
NC
Other
Enumeration date
06/12/2018
Last updated
06/10/2019
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