Individual
MISS ASHLEY MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, DOR
Contact information
Practice address
917 7TH AVE, LONGVIEW, WA 98632-2601
(360) 425-5910
(360) 425-0318
Mailing address
917 7TH AVE, LONGVIEW, WA 98632-2601
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
60216733
WA
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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