Provider Demographics
NPI:1952819286
Name:WIENS, SHAINA LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:LYNN
Last Name:WIENS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-2611
Mailing Address - Country:US
Mailing Address - Phone:785-877-0550
Mailing Address - Fax:785-874-4615
Practice Address - Street 1:113 N STATE ST
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-2046
Practice Address - Country:US
Practice Address - Phone:785-877-0550
Practice Address - Fax:785-874-4615
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS-4050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist