Provider Demographics
NPI:1073004115
Name:STOOPS, MELINDA KAREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:KAREN
Last Name:STOOPS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 KEVIN CIR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3015
Mailing Address - Country:US
Mailing Address - Phone:508-962-3688
Mailing Address - Fax:
Practice Address - Street 1:12 KEVIN CIR
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3015
Practice Address - Country:US
Practice Address - Phone:508-962-3688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7524103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling