Individual
SANDRA CHERYL MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5400 W FRANKLIN RD, SUITE H, BOISE, ID 83705
(208) 345-1170
(208) 345-3502
Mailing address
PO BOX 9, 211 16TH AVE N, NAMPA, ID 83653-0009
(208) 467-4431
(208) 467-7684
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC260
ID
Other
Enumeration date
03/22/2006
Last updated
09/09/2009
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