Provider Information for 1184763955
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Ms. LESLIE MARIE MCCULLOUGH LSCSW, LCSW
Other Names:Former Name:Dr. LESLIE MARIE MCCULLOUGHSex: Female
NPI: 1184763955
Last Updated: 2020-03-03
Certification Date: 2020-03-03
Certification Date: 2020-03-03
Details
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NPI | 1184763955 | ||||||||||||||||
Enumeration Date | 2007-02-06 | ||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||
Sole Proprietor | YES | ||||||||||||||||
Status | Active | ||||||||||||||||
Mailing Address | PO BOX 4171 TOPEKA, KS 66604-0171 United States Phone: 210-885-8696 | Fax: | ||||||||||||||||
Primary Practice Address | 1212 SW MULVANE ST TOPEKA, KS 66604-1442 United States Phone: 210-885-8696 | Fax: | ||||||||||||||||
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