MEDICARE: KIRSHINA WYNN MA CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	102045	TX

General Provider Information

NPI Number	:	1437303534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSHINA WYNN MA CCC/SLP

Provider Business Mailing Address
First Line	:	3211 RUFFIN GREEN CT
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-8773
Country	:	US
Telephone Number	:	409-457-7443
Fax Number	:	281-416-1799

Provider Business Practice Location Address
First Line	:	3211 RUFFIN GREEN CT
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-8773
Country	:	US
Telephone Number	:	409-457-7443
Fax Number	:	281-416-1799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2008
Last Update Date	:	05/08/2026

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Directions to “ KIRSHINA WYNN MA CCC/SLP” Practice Location

Language	Start Address	Practice Location

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