Provider Demographics
NPI:1164016051
Name:MAY, ANNASTASIA ALEXANDRIA (RBT)
Entity Type:Individual
Prefix:MISS
First Name:ANNASTASIA
Middle Name:ALEXANDRIA
Last Name:MAY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2539
Mailing Address - Country:US
Mailing Address - Phone:334-350-0711
Mailing Address - Fax:334-475-4059
Practice Address - Street 1:204 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2539
Practice Address - Country:US
Practice Address - Phone:334-350-0711
Practice Address - Fax:334-475-4059
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician