BLAKE MCCULLOUGH

EAST LANSING, MI
NPI1679073092
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MI  6801104012)
Additional Taxonomies104100000X Social Worker
(Licence: MI  6801100146)
Enumeration Date2018-02-13
Last Update Date2023-08-08
Business Address
BLAKE MCCULLOUGH LMSW
2900 HANNAH BLVD STE 104
EAST LANSING, MI 48823-5380
Phone number: 517-253-6320
Mailing Address
BLAKE MCCULLOUGH LMSW
2900 HANNAH BLVD STE 104
EAST LANSING, MI 48823-5380
Phone number: 517-253-6320