Provider Demographics
NPI:1760743025
Name:THE MAY CENTER FOR AUTISM SPECTRUM DISORDERS
Entity Type:Organization
Organization Name:THE MAY CENTER FOR AUTISM SPECTRUM DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:STULL
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPA BCBA
Authorized Official - Phone:910-333-0814
Mailing Address - Street 1:14 PACELLA PARK DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1756
Mailing Address - Country:US
Mailing Address - Phone:781-437-1200
Mailing Address - Fax:781-551-9880
Practice Address - Street 1:102 ELIZABETH ST STE C
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5679
Practice Address - Country:US
Practice Address - Phone:910-333-0814
Practice Address - Fax:910-333-0817
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MAY INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health