Individual
MRS. ANNETTE VICTORIA MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-5102
(973) 972-5725
Mailing address
10 SHELDON TER, NEWARK, NJ 07106-3315
(973) 972-5102
(973) 972-5725
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TR 00750
NJ
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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