Individual
MRS. DEBORAH MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3737 LAKE AVE, FORT WAYNE, IN 46805-5554
(260) 422-1680
(260) 422-1555
Mailing address
11232 BITTERSWEET CREEK RUN, FORT WAYNE, IN 46814-3286
(260) 436-8053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IN
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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