Provider Demographics
NPI:1942691738
Name:SIPLIN, SHAYNA SHERIE (MS)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:SHERIE
Last Name:SIPLIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-0541
Mailing Address - Country:US
Mailing Address - Phone:321-239-7248
Mailing Address - Fax:
Practice Address - Street 1:4902 EISENHOWER BLVD
Practice Address - Street 2:315
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6310
Practice Address - Country:US
Practice Address - Phone:813-290-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-15
Last Update Date:2015-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health