Individual
MS. DONNA C. CULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Mailing address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042379A
IN
103TF0200X
Forensic Psychologist
20042379A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000640783
ANTHEM
IN
01
—
12018783
CAQH
IN
01
—
20042379A
LICENSE - PSYCHOLOGIST
IN
05
—
200967750
—
IN
Enumeration date
10/01/2009
Last updated
10/09/2015
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