Individual
DR. KATINA LYNNIECE SHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1061 HARMON AVE., STE 1D03 WINN ARMY COMMUNITY HOSPITAL, FT. STEWART, GA 31314-5674
(912) 435-7016
Mailing address
1061 HARMON AVE., STE 1D03 WINN ARMY COMMUNITY HOSPITAL, FT. STEWART, GA 31314-5674
(912) 435-7016
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2003023867
MO
Other
Enumeration date
05/08/2006
Last updated
09/28/2010
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