Mccullough, Leisa Annette

Mccullough, Leisa Annette is an sole proprietor health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mccullough, Leisa Annette can be contacted via phone (662) 397-8964.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (662) 397-8964
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X S3909 Mississippi

Profile Details

NPI number 1699201715
LBN Legal business name Mccullough, Leisa Annette
Credentials CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2017
Last updated May 10th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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