Provider Demographics
NPI:1407102346
Name:MINTER, STEVEN SHELBY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SHELBY
Last Name:MINTER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 S ALEXANDER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-5053
Mailing Address - Country:US
Mailing Address - Phone:813-385-7041
Mailing Address - Fax:
Practice Address - Street 1:607 S ALEXANDER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-5053
Practice Address - Country:US
Practice Address - Phone:813-385-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8553103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical