Individual
JACQUELYN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 LEE STREET MAILBOX 800744, CHARLOTTESVILLE, VA 22908-0001
(434) 924-1931
(434) 244-4451
Mailing address
1215 LEE STREET MAILBOX 800744, CHARLOTTESVILLE, VA 22908-0001
(434) 924-1931
(434) 244-4451
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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