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Individual

MRS. MARILYN J CULLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1742 FALLS BLVD. SUITE 5, THE LOGAN CENTER, WYNNE, AR 72396
(870) 208-9333
(870) 208-9229
Mailing address
139 COUNTY ROAD 395, WYNNE, AR 72396
(870) 238-5596
(870) 208-9229

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P9807016
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5U425
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/28/2006
Last updated
07/08/2007
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