Provider Demographics
NPI:1053786277
Name:MCCRINK-SHENDOCK, DEANNA M (MS)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:M
Last Name:MCCRINK-SHENDOCK
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 1:2697 COUNTY ROUTE 17
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13493-2403
Mailing Address - Country:US
Mailing Address - Phone:315-335-2772
Mailing Address - Fax:
Practice Address - Street 1:2697 COUNTY ROUTE 17
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13493-2403
Practice Address - Country:US
Practice Address - Phone:315-335-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist