Basic Information
| Provider Information | |||||||||
| NPI: | 1912647678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAY | ||||||||
| FirstName: | THERESE | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 JAY CIR | ||||||||
| Address2: | |||||||||
| City: | WINDSOR | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060952443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608165919 | ||||||||
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| Practice Location | |||||||||
| Address1: | 275 STEELE RD | ||||||||
| Address2: | |||||||||
| City: | WEST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061172716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605708200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2022 | ||||||||
| LastUpdateDate: | 03/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 6080 | CT | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.