Provider Demographics
NPI:1275928806
Name:MALOUKIS, MELINA L
Entity Type:Individual
Prefix:MS
First Name:MELINA
Middle Name:L
Last Name:MALOUKIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 NW 44TH ST APT G
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5951
Mailing Address - Country:US
Mailing Address - Phone:512-888-1282
Mailing Address - Fax:
Practice Address - Street 1:1817 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3614
Practice Address - Country:US
Practice Address - Phone:580-357-3857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker