JALISA JONIQUE MCCULLOUGH

ROCHESTER, NY
NPI1730702077
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY  402978)
Enumeration Date2020-05-21
Last Update Date2023-07-03
Business Address
JALISA JONIQUE MCCULLOUGH PMHNP
300 CRITTENDEN BOULEVARD BOX PSYCH
ROCHESTER, NY 14642-0001
Phone number: 585-275-3592
Mailing Address
JALISA JONIQUE MCCULLOUGH PMHNP
604 SUBURBAN CT APT 2
ROCHESTER, NY 14620-3837
Phone number: 585-309-2363
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