Provider Demographics
NPI:1477104917
Name:CAINE, SHAYNA LEE (MA, SLP)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:LEE
Last Name:CAINE
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 MAPLEVALE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-4819
Mailing Address - Country:US
Mailing Address - Phone:814-591-2427
Mailing Address - Fax:
Practice Address - Street 1:186 LAKE SHORE DR W
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-1437
Practice Address - Country:US
Practice Address - Phone:716-366-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist