Provider Demographics
NPI:1497342521
Name:MCCULLAH, DARNITA
Entity Type:Individual
Prefix:
First Name:DARNITA
Middle Name:
Last Name:MCCULLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 CENTRAL PL S APT B10
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7571
Mailing Address - Country:US
Mailing Address - Phone:206-795-7708
Mailing Address - Fax:
Practice Address - Street 1:1844 CENTRAL PL S APT B10
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7571
Practice Address - Country:US
Practice Address - Phone:206-795-7708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist