Provider Demographics
NPI:1760763841
Name:CUNHA, SHEYTOPHIA RENEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHEYTOPHIA
Middle Name:RENEE
Last Name:CUNHA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2258 COACHMAN LOOP
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4047
Mailing Address - Country:US
Mailing Address - Phone:954-882-5734
Mailing Address - Fax:
Practice Address - Street 1:2258 COACHMAN LOOP
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4047
Practice Address - Country:US
Practice Address - Phone:954-882-5734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLSS1338103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst