Individual
DR. PATRICIA ANN MCCULLAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7205 MAIN ST, SUITE #3, MANCHESTER CENTER, VT 05255-9312
(802) 366-9122
Mailing address
PO BOX 987, MANCHESTER CENTER, VT 05255-0987
(802) 366-9122
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
048-0000786
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007296
—
VT
01
—
383797
MVP
VT
01
—
VN359401
DOMHA MCR
VT
Enumeration date
07/04/2006
Last updated
03/31/2008
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