| Doctor Name: | MS. CAROL DENISE MCCULLEY |
| NPI Number: | 1962507533 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CERT ADDICTIONS SPEC |
| License Number: | 03026319 |
| Business Practice Address: | 441 N Main St Alturas, CA - 96101 |
| Business Phone Number: | 5302336319 |
| Business Fax Number: | 5302335311 |
| Mailing Address: | Po Box 1374, ALTURAS |
| State: | CA |
| Postal Code: | 96101 |
| Phone Number: | 5302334209 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 03026319 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |