Healthcare Provider Details

I. General information

NPI: 1235496696
Provider Name (Legal Business Name): MELANIE VAN NOY MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2012
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14517 MEADOWLAND CIR
NEWARK TX
76071-9103
US

IV. Provider business mailing address

14517 MEADOWLAND CIR
NEWARK TX
76071-9103
US

V. Phone/Fax

Practice location:
  • Phone: 817-381-8272
  • Fax:
Mailing address:
  • Phone: 817-381-8272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number106628
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: