Doctor Name: | DR. PATRICIA ANN MCCULLAGH |
NPI Number: | 1255361267 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 048-0000786 |
Business Practice Address: | 7205 Main St Suite #3 Manchester Center, VT - 052559312 |
Business Phone Number: | 8023669122 |
Business Fax Number: | |
Mailing Address: | Po Box 987, MANCHESTER CENTER |
State: | VT |
Postal Code: | 052550987 |
Phone Number: | 8023669122 |
Fax Number: | |
NPI Enumeration Date: | 07/04/2006 |
NPI Last Update Date: | 03/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 048-0000786 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |