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1629759154
MARIO MCCULLUM
SAN DIEGO, CA
NPI
1629759154
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-07-27
Last Update Date
2023-07-27
Business Address
MARIO MCCULLUM
5855 STREAMVIEW DR
SAN DIEGO, CA 92105-3910
Phone number: 619-287-5460
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Mailing Address
MARIO MCCULLUM
5855 STREAMVIEW DR
SAN DIEGO, CA 92105-3910
Phone number: 619-287-5460
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