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General NPI Number Information
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NPI Number | 1922646561
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Entity Type | Individual
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Provider Name | TINA THOMAS PH.D, M.ED, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 8080 INDEPENDENCE PKWY STE 200
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City | PLANO
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State | TX
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Zip | 75025-4002
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Country | US
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Telephone | 972-954-6401
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 118434
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City | CARROLLTON
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State | TX
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Zip | 75011-8434
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Country | US
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Telephone | 214-566-2036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 82529
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License Number State | TX
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