Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | AZ |
NPI | 1083811020 |
---|---|
Provider Name | June H Mcculley |
First Address | Peoria, AZ 85382-2214 |
Second Address | Peoria, AZ 85382-2214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 25/07/2007 |