Provider Demographics
NPI:1366096141
Name:WINN, RENEE ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:ELIZABETH
Last Name:WINN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:ELIZABETH
Other - Last Name:SCHARINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3820 HARVEST CT
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-8217
Mailing Address - Country:US
Mailing Address - Phone:920-750-9885
Mailing Address - Fax:
Practice Address - Street 1:800 RIVERSIDE DRIVE DR. 902 BUILDING
Practice Address - Street 2:SPEECH THERAPY
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981
Practice Address - Country:US
Practice Address - Phone:920-750-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4879-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist