Individual
LISA MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 688-2105
Mailing address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 688-2105
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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