Provider Demographics
NPI:1710264601
Name:LITTLETON, MELISSA A (MS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 JEFFERSON ST APT B
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5012
Mailing Address - Country:US
Mailing Address - Phone:405-882-9025
Mailing Address - Fax:405-702-9031
Practice Address - Street 1:923 JEFFERSON ST
Practice Address - Street 2:APT. B
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5012
Practice Address - Country:US
Practice Address - Phone:405-882-9025
Practice Address - Fax:405-702-9031
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist