Provider Demographics
NPI:1487039681
Name:WEINSTEIN, SHAYNE MELISSA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHAYNE
Middle Name:MELISSA
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 NORWALK LN
Mailing Address - Street 2:APT. 5
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-3791
Mailing Address - Country:US
Mailing Address - Phone:503-516-2006
Mailing Address - Fax:
Practice Address - Street 1:1302 NORWALK LN
Practice Address - Street 2:APT. 5
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-3791
Practice Address - Country:US
Practice Address - Phone:503-516-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist