Provider Demographics
NPI:1598536302
Name:MELTON, KRISTEN ARETTA (BCC, BCC-MH)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ARETTA
Last Name:MELTON
Suffix:
Gender:F
Credentials:BCC, BCC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 NE 13TH ST.,
Mailing Address - Street 2:DEPT. 125
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-456-5138
Mailing Address - Fax:
Practice Address - Street 1:921 NE 13TH ST.,
Practice Address - Street 2:DEPT. 125
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-456-5138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral