Individual
AMANDA MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 MARKET ST STE 119, BOARDMAN, OH 44512-2616
(330) 971-9117
Mailing address
5500 MARKET ST STE 119, BOARDMAN, OH 44512-2616
(330) 971-9117
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21-151273
OH
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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