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Individual

DR. PATRICIA ANN MCCULLAGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

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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