Provider Demographics
NPI:1790219947
Name:WINBURN, SHIRLANE DIANE (BS PSYCHOLOGY)
Entity type:Individual
Prefix:MRS
First Name:SHIRLANE
Middle Name:DIANE
Last Name:WINBURN
Suffix:
Gender:F
Credentials:BS PSYCHOLOGY
Other - Prefix:MRS
Other - First Name:SHIRLANE
Other - Middle Name:DIANE
Other - Last Name:ROJAS WINBURN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1155 KELLY JOHNSON BLVD # 1
Mailing Address - Street 2:STE 150
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1155 KELLY JOHNSON BLVD
Practice Address - Street 2:STE 150
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3932
Practice Address - Country:US
Practice Address - Phone:910-977-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst