Organization Name: | J MELTON LLC |
NPI Number: | 1477868594 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUNE MELTON (CEO) |
Mailing Address: | 3362 N 367 Rd Holdenville |
State: | OK US |
Postal Code: | 748489473 |
Phone Number: | 4052212610 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2010 |
NPI Last Update Date: | 08/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |