Individual
DR. MONA MCCULLOUGH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
13301 N MERIDIAN AVE, BLDG 100, OKLAHOMA CITY, OK 73120-9369
(405) 752-9500
(405) 752-9571
Mailing address
13301 N MERIDIAN AVE, BLDG 100, OKLAHOMA CITY, OK 73120-9369
(405) 752-9500
(405) 752-9571
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
814
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100840340A
—
OK
01
—
23727800173120A029
TRICARE
OK
01
—
7342420
AETNA
OK
Enumeration date
05/05/2006
Last updated
07/08/2007
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