Individual
LESLI BACON MCCULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 S AVALON ST, WEST MEMPHIS, AR 72301-4109
(870) 400-3481
Mailing address
1696 CARRUTHERS PL, MEMPHIS, TN 38112-5208
(901) 604-7611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3760
TN
235Z00000X
Speech-Language Pathologist
Primary
SP8000
AR
Other
Enumeration date
06/13/2007
Last updated
03/03/2026
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