Mcculloch, Krista M
Mcculloch, Krista M is an individual health care provider with primary practice located at 1627 Henthorne Dr Ste C , Maumee OH 43537-1370. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mcculloch, Krista M can be contacted via phone (419) 491-0420.Contact Information
Primary practice address
1627 Henthorne Dr Ste C
Maumee OH 43537-1370
Phone: (419) 491-0420
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | S.0800738 | Ohio |
Profile Details
| NPI number | 1124453907 |
|---|---|
| LBN Legal business name | Mcculloch, Krista M |
| Credentials | LSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 11th, 2013 |
| Last updated | Mar 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124453907 | NPPES |
| Ohio | MEDICAID | 2871101 |
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