Provider Demographics
NPI:1821522640
Name:BENDLE, SHAYNA ANNE (MA, LLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAYNA
Middle Name:ANNE
Last Name:BENDLE
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2094 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3502
Mailing Address - Country:US
Mailing Address - Phone:810-423-5849
Mailing Address - Fax:
Practice Address - Street 1:1286 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3457
Practice Address - Country:US
Practice Address - Phone:810-407-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015825103TC0700X
MI6361007108103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical