| Doctor Name: | DR. KATINA LYNNIECE SHINE |
| NPI Number: | 1104875038 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 2003023867 |
| Business Practice Address: | 1061 Harmon Ave. Ste 1d03 Winn Army Community Hospital Ft. Stewart, GA - 313145674 |
| Business Phone Number: | 9124357016 |
| Business Fax Number: | |
| Mailing Address: | 1061 Harmon Ave., Ste 1d03 Winn Army Community Hospital FT. STEWART |
| State: | GA |
| Postal Code: | 313145674 |
| Phone Number: | 9124357016 |
| Fax Number: | |
| NPI Enumeration Date: | 05/08/2006 |
| NPI Last Update Date: | 09/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2003023867 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |