Organization
LEGENDS EQUESTRIAN THERAPY
Active
Other names
Legends Equestrian Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE M. MCCULLOUGH PHD, LSCSW, LCSW (PSYCHOTHERAPIST)
(210) 885-8696
Entity
Organization
Contact information
Practice address
1212 SW MULVANE ST, TOPEKA, KS 66604-1442
(210) 885-8696
Mailing address
PO BOX 4171, TOPEKA, KS 66604-0171
(210) 885-8696
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201201540A
—
KS
Enumeration date
03/03/2020
Last updated
03/03/2020
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