Individual
TIFFANY LYNN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Contact information
Practice address
2508 SE 20TH ST, BENTONVILLE, AR 72712-4008
(479) 273-9088
(479) 845-2111
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 872-2441
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2096-C
TX
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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