MEDICARE: DR. MELODY JOY SHEPHERD VALLEY EDD, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	108530	TX

General Provider Information

NPI Number	:	1326718602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELODY JOY SHEPHERD VALLEY EDD, CCC-SLP

Provider Business Mailing Address
First Line	:	629 W CHERYL AVE
Second Line	:
City	:	HURST
State	:	TX
Zip	:	76053-4903
Country	:	US
Telephone Number	:	817-874-4978
Fax Number	:

Provider Business Practice Location Address
First Line	:	8101 BOAT CLUB RD STE 330
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3633
Country	:	US
Telephone Number	:	682-498-3927
Fax Number	:	214-935-2457

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	05/16/2024

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Directions to “ DR. MELODY JOY SHEPHERD VALLEY EDD, CCC-SLP” Practice Location

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