Provider Demographics
NPI:1215019310
Name:SWEENEY, MELISSA H (MS)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:H
Last Name:SWEENEY
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 1:1966 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7298
Mailing Address - Country:US
Mailing Address - Phone:972-883-3010
Mailing Address - Fax:972-883-3022
Practice Address - Street 1:1966 INWOOD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7298
Practice Address - Country:US
Practice Address - Phone:972-883-3000
Practice Address - Fax:972-883-3068
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87309TOtherBLUE CROSS BLUE SHIELD
TX005907302Medicaid
TX87309TOtherBLUE CROSS BLUE SHIELD