Individual
MS. JENNIFER LYNN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
909 MISSOURI BLVD, SUITE F, JEFFERSON CITY, MO 65109-1771
(573) 584-0158
(573) 584-0159
Mailing address
909 MISSOURI BLVD, SUITE F, JEFFERSON CITY, MO 65109-1771
(573) 584-0158
(573) 584-0159
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000949
MO
Other
Enumeration date
06/27/2006
Last updated
07/09/2007
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