MEDICARE: ALYSE MAY CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	30002392	NC

General Provider Information

NPI Number	:	1104487560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSE MAY CCC-SLP

Provider Business Mailing Address
First Line	:	714 GREEN VALLEY RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-7018
Country	:	US
Telephone Number	:	336-370-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 MARTIN LUTHER KING JR DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-3129
Country	:	US
Telephone Number	:	336-370-8640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	04/14/2026

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Directions to “ ALYSE MAY CCC-SLP” Practice Location

Language	Start Address	Practice Location

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