Individual
MISS AMANDA JO MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., B.C.B.A.
Contact information
Practice address
4001 WESTERLY PL, SUITE 110, NEWPORT BEACH, CA 92660-2315
(949) 756-8799
Mailing address
4001 WESTERLY PL, SUITE 110, NEWPORT BEACH, CA 92660-2315
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/09/2010
Last updated
11/21/2016
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