Provider Demographics
NPI:1609106426
Name:SHINEDLING AND SHINEDLING PLLC
Entity Type:Organization
Organization Name:SHINEDLING AND SHINEDLING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHINEDLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:435-275-2087
Mailing Address - Street 1:1795 N SNOW CANYON PKWY
Mailing Address - Street 2:UNIT 36
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5851
Mailing Address - Country:US
Mailing Address - Phone:435-275-2087
Mailing Address - Fax:
Practice Address - Street 1:1795 N SNOW CANYON PKWY
Practice Address - Street 2:UNIT 36
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-5851
Practice Address - Country:US
Practice Address - Phone:435-275-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6906880-2501261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)