Individual
MR. PATRICK JAMES MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
11395 NW MCCOIN RD, PRINEVILLE, OR 97754-8287
(541) 410-0430
Mailing address
11395 NW MCCOIN RD, PRINEVILLE, OR 97754-8287
(541) 410-0430
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4606
OR
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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