Individual
MELINDA CLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 ALEXANDER ST, JONESBORO, LA 71251-2001
(318) 459-6795
Mailing address
1000 CHINABERRY DR STE 903, BOSSIER CITY, LA 71111-2455
(318) 459-6795
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
7224
OK
1041C0700X
Clinical Social Worker
Primary
7224
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200323940
—
OK
Enumeration date
10/30/2017
Last updated
01/11/2022
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