Provider Demographics
NPI:1497892053
Name:MAY, TERESA A (SLP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:A
Last Name:MAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:A
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:3315 KETHLEY RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-9638
Mailing Address - Country:US
Mailing Address - Phone:405-273-5801
Mailing Address - Fax:405-878-3794
Practice Address - Street 1:3315 KETHLEY RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-9638
Practice Address - Country:US
Practice Address - Phone:405-273-5801
Practice Address - Fax:405-878-3794
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100503235Z00000X
OK4524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T3014OtherBCBS PROVIDER NUMBER
TX126779OtherCHIP PROVIDER NUMBER
TX169697301Medicaid