Individual
MS. LYNNE M MCCULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR,MAC,LCAC
Contact information
Practice address
6531 W WASHINGTON ST, INDIANAPOLIS, IN 46241-3026
(317) 241-9644
(317) 241-9730
Mailing address
1138 S HIGH SCHOOL RD, INDIANAPOLIS, IN 46241-3122
(317) 241-9644
(317) 241-9730
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000236A
IN
Other
Enumeration date
01/24/2011
Last updated
09/10/2012
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