Provider Demographics
NPI:1053040659
Name:GILMORE-THOMAS, ADRIENNE DORA (PHD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DORA
Last Name:GILMORE-THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 N SAM HOUSTON PKWY E APT 521
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2966
Mailing Address - Country:US
Mailing Address - Phone:832-329-5422
Mailing Address - Fax:
Practice Address - Street 1:352 NORTH ST. PAUL STREET
Practice Address - Street 2:SUITE 3100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201
Practice Address - Country:US
Practice Address - Phone:929-904-0159
Practice Address - Fax:855-461-3542
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional