Provider Demographics
NPI:1871181511
Name:THOMAS, TRIKEENA (MED)
Entity Type:Individual
Prefix:MRS
First Name:TRIKEENA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 LYONS RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1875
Mailing Address - Country:US
Mailing Address - Phone:937-520-7745
Mailing Address - Fax:
Practice Address - Street 1:1119 LYONS RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1875
Practice Address - Country:US
Practice Address - Phone:937-520-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional