Healthcare Provider Details

I. General information

NPI: 1013291996
Provider Name (Legal Business Name): NATALIE LYNN SHINER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2011
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6928 JAMESTOWN MANOR DR
RIVERVIEW FL
33578-8303
US

IV. Provider business mailing address

6928 JAMESTOWN MANOR DR
RIVERVIEW FL
33578-8303
US

V. Phone/Fax

Practice location:
  • Phone: 813-433-6441
  • Fax:
Mailing address:
  • Phone: 813-433-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: