| Doctor Name: | MRS. ELIZABETH SQUYRES MELANCON |
| NPI Number: | 1437455680 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | 9029 |
| Business Practice Address: | 120 W Mark St Marksville, LA - 713512306 |
| Business Phone Number: | 2253241516 |
| Business Fax Number: | |
| Mailing Address: | 301 N Sewell Pl, BUNKIE |
| State: | LA |
| Postal Code: | 713221939 |
| Phone Number: | 2253241516 |
| Fax Number: | 3183469054 |
| NPI Enumeration Date: | 02/07/2011 |
| NPI Last Update Date: | 02/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 9029 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |