Provider Demographics
NPI:1750790911
Name:WINNE, TARYN (MSED, CAS)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:WINNE
Suffix:
Gender:F
Credentials:MSED, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 APPLE ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2803
Mailing Address - Country:US
Mailing Address - Phone:845-750-2660
Mailing Address - Fax:
Practice Address - Street 1:11 CARROLL ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5136
Practice Address - Country:US
Practice Address - Phone:845-563-0671
Practice Address - Fax:845-563-0707
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool