Provider Demographics
NPI:1154488971
Name:PEDDY, DONNA LYNN (MED, LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LYNN
Last Name:PEDDY
Suffix:
Gender:F
Credentials:MED, LPC, LMFT
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:LYNN
Other - Last Name:PEDDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LPC, LMFT
Mailing Address - Street 1:6750 HILLCREST PLAZA DR STE 304
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1447
Mailing Address - Country:US
Mailing Address - Phone:214-349-5564
Mailing Address - Fax:214-343-8111
Practice Address - Street 1:6750 HILLCREST PLAZA DR STE 304
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1447
Practice Address - Country:US
Practice Address - Phone:214-349-5564
Practice Address - Fax:214-343-8111
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04806101YM0800X
TX003704038952106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist