| Leilani Ray Cullen Ma Lmft | |
|
203 N 6th St Ste A Douglas WY 82633-2411 | |
| (307) 242-1472 | |
| (307) 624-6254 |
| Full Name | Leilani Ray Cullen Ma Lmft |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 203 N 6th St Ste A, Douglas, Wyoming |
| Authorized Official Name and Position | Leilani Cullen (PRESIDENT) |
| Authorized Official Contact | 7199640833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leilani Ray Cullen Ma Lmft 680 N Wind River Dr Douglas WY 82633-2029 Ph: (719) 964-0833 | Leilani Ray Cullen Ma Lmft 203 N 6th St Ste A Douglas WY 82633-2411 Ph: (307) 242-1472 |
| NPI Number | 1942831185 |
|---|---|
| Provider Enumeration Date | 01/27/2020 |
| Last Update Date | 01/27/2023 |
| Certification Date | 01/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942831185 | NPI | - | NPPES |
| 14924323 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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