Provider Demographics
NPI:1679071369
Name:THOMAS, PEDRA LYNNE (MS)
Entity type:Individual
Prefix:
First Name:PEDRA
Middle Name:LYNNE
Last Name:THOMAS
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 1:12959 JUPITER RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5223
Mailing Address - Country:US
Mailing Address - Phone:586-696-3500
Mailing Address - Fax:
Practice Address - Street 1:12959 JUPITER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5223
Practice Address - Country:US
Practice Address - Phone:586-696-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional