Individual
ALICIA D MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4400 BROADWAY BLVD STE 300, KANSAS CITY, MO 64111-3342
(816) 932-1711
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131
(816) 932-1711
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0548330
KS
2084P0800X
Psychiatry Physician
Primary
2500090246
MO
Other
Enumeration date
06/24/2019
Last updated
09/05/2023
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