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1699201715
LEISA ANNETTE MCCULLOUGH
JACKSON, MS
NPI
1699201715
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MS S3909)
Enumeration Date
2017-05-10
Last Update Date
2017-05-10
Business Address
-- LEISA ANNETTE MCCULLOUGH CCC-SLP
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 662-397-8964
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Mailing Address
-- LEISA ANNETTE MCCULLOUGH CCC-SLP
144 HUBER ST
MADISON, MS 39110-6983
Phone number: 662-397-8964
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