Provider Demographics
NPI:1952785149
Name:MAY, LYNN MICHA (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MICHA
Last Name:MAY
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:MISS
Other - First Name:LYNN
Other - Middle Name:MICHA
Other - Last Name:NADEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCCSLP
Mailing Address - Street 1:4116 SOUTH CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:12850
Mailing Address - Country:US
Mailing Address - Phone:413-218-0703
Mailing Address - Fax:
Practice Address - Street 1:112 SK. BOWL ROAD
Practice Address - Street 2:ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER
Practice Address - City:NORTH CREEK
Practice Address - State:NY
Practice Address - Zip Code:12853
Practice Address - Country:US
Practice Address - Phone:518-251-2447
Practice Address - Fax:518-251-4207
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist