Doctor Name: | GARY MCCULLOUGH |
NPI Number: | 1346637642 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D,CCC-SLP |
License Number: | 11215 |
Business Practice Address: | 400 University Hall Dr Room 216 Boone, NC - 286082102 |
Business Phone Number: | 8282627675 |
Business Fax Number: | 8282627680 |
Mailing Address: | 400 University Hall Dr, Room 216 BOONE |
State: | NC |
Postal Code: | 286082102 |
Phone Number: | 8282627675 |
Fax Number: | 8282627680 |
NPI Enumeration Date: | 04/24/2015 |
NPI Last Update Date: | 04/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 11215 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |