Provider Demographics
NPI:1942345012
Name:LEVENS, MELINDA (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:LEVENS
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 TREE HILL CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-5228
Mailing Address - Country:US
Mailing Address - Phone:972-207-8823
Mailing Address - Fax:
Practice Address - Street 1:800 TREE HILL CT
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5228
Practice Address - Country:US
Practice Address - Phone:972-207-8823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175020001Medicaid