Provider Demographics
NPI:1275602658
Name:MAY, THERESE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:THERESE
Middle Name:MARIE
Last Name:MAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10035 SLIDING HILL RD STE 205
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7953
Mailing Address - Country:US
Mailing Address - Phone:804-550-1229
Mailing Address - Fax:
Practice Address - Street 1:10035 SLIDING HILL RD STE 205
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7953
Practice Address - Country:US
Practice Address - Phone:804-550-1229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1105103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical