Individual
CORINA MCCULLOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8616 NORTHERN AVE, ROCKFORD, IL 61107-5309
(815) 332-8003
(815) 332-6090
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 391-5600
(815) 316-4726
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178011788
IL
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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