Provider Demographics
NPI:1750633830
Name:FRANKLIN-MELTON, STEPHANIE L
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:L
Last Name:FRANKLIN-MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:L
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:132 OAK CIR
Mailing Address - Street 2:
Mailing Address - City:GRAMBLING
Mailing Address - State:LA
Mailing Address - Zip Code:71245-2810
Mailing Address - Country:US
Mailing Address - Phone:318-607-8810
Mailing Address - Fax:
Practice Address - Street 1:132 OAK CIR
Practice Address - Street 2:
Practice Address - City:GRAMBLING
Practice Address - State:LA
Practice Address - Zip Code:71245-2810
Practice Address - Country:US
Practice Address - Phone:318-607-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA62051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical