| Doctor Name: | MS. MARY ANGELA MACCULLOCH |
| NPI Number: | 1023369675 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 075757-1 |
| Business Practice Address: | Psc 473 Box 116 Fpo, AP - 963499998 |
| Business Phone Number: | 0468167878 |
| Business Fax Number: | |
| Mailing Address: | Psc 473, Box 116 FPO |
| State: | AP |
| Postal Code: | 963499998 |
| Phone Number: | 7185546973 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2012 |
| NPI Last Update Date: | 09/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 075757-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |