Provider Demographics
NPI:1245834373
Name:MINEAR, KACEE PAYTON
Entity type:Individual
Prefix:
First Name:KACEE
Middle Name:PAYTON
Last Name:MINEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 CITRUS TOWER BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6501
Mailing Address - Country:US
Mailing Address - Phone:352-223-1999
Mailing Address - Fax:352-600-6119
Practice Address - Street 1:355 CITRUS TOWER BLVD STE 116
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6501
Practice Address - Country:US
Practice Address - Phone:352-223-1999
Practice Address - Fax:352-600-6119
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst