Provider Demographics
NPI:1497166540
Name:JAYNES, MELINDA A (BS)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:A
Last Name:JAYNES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:A
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1203 MCCLOUD ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-7150
Mailing Address - Country:US
Mailing Address - Phone:918-685-2224
Mailing Address - Fax:918-686-8881
Practice Address - Street 1:1203 MCCLOUD ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-7150
Practice Address - Country:US
Practice Address - Phone:918-685-2224
Practice Address - Fax:918-686-8881
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health