Individual
MANDI JO MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
318 E PARK ST, CROWLEY, LA 70526-2468
(337) 280-0539
(337) 785-1188
Mailing address
137 TIMBERLAND RIDGE BLVD, LAFAYETTE, LA 70507-2743
(337) 280-0539
(337) 785-1188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7242
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1549185
—
LA
Enumeration date
04/11/2007
Last updated
12/20/2013
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