| Doctor Name: | DR. VASHTI S. WINES |
| NPI Number: | 1295164689 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D |
| License Number: | |
| Business Practice Address: | 100 S Main St Suite 208 Sayville, NY - 117823100 |
| Business Phone Number: | 6316266217 |
| Business Fax Number: | |
| Mailing Address: | 11 Danamarie Ln, EAST PATCHOGUE |
| State: | NY |
| Postal Code: | 117725609 |
| Phone Number: | 6316266217 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 08/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |