Sara McCullough
Social Worker, Clinical in Bloomington, IL. Individual provider (NPI-1).
NPI number1366868366
StatusActive
Last updated in NPPESMar 14, 2014
Details
- NPI
- 1366868366
- Entity type
- Individual (NPI-1)
- Name
- Sara McCullough
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2014
- Last updated
- Mar 14, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149.016095 | IL | Yes |
Practice location
1003 Martin Luther King DrBloomington, IL 61701-1429
Phone 309-820-3654
Mailing address
1003 Martin Luther King DrBloomington, IL 61701-1429
Phone 309-820-3654
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