Healthcare Provider Details

I. General information

NPI: 1073761581
Provider Name (Legal Business Name): NATALIE BOGGAN MAY M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15305 HIGHWAY 15
DECATUR MS
39327-7208
US

IV. Provider business mailing address

215 CROWS NEST CIR
DECATUR MS
39327-8929
US

V. Phone/Fax

Practice location:
  • Phone: 601-635-4041
  • Fax:
Mailing address:
  • Phone: 601-416-4982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12073096
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: