Individual
MR. JAMUS EDWARD MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1799 N LAKES PL, MERIDIAN, ID 83646-1833
(208) 509-0543
Mailing address
1799 N LAKES PL, MERIDIAN, ID 83646-1833
(208) 509-0543
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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