Individual
DOMINIQUE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1752 CAPITAL ST STE 100, ELGIN, IL 60124-7896
(847) 695-3680
Mailing address
1752 CAPITAL ST STE 100, ELGIN, IL 60124-7896
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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