Provider Demographics
NPI:1164885539
Name:MINTON, TRICIA BRIEDE (MD)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:BRIEDE
Last Name:MINTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:BRIEDE
Other - Last Name:MCCUTCHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4371 FERGUSON DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1668
Mailing Address - Country:US
Mailing Address - Phone:513-752-3650
Mailing Address - Fax:513-752-3387
Practice Address - Street 1:4371 FERGUSON DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1668
Practice Address - Country:US
Practice Address - Phone:513-752-3650
Practice Address - Fax:513-752-3387
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.131106208000000X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0181188Medicaid