Provider Demographics
NPI:1881121887
Name:DROGE, LYNNETTE N (PTA, LMT, LBSW)
Entity type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:N
Last Name:DROGE
Suffix:
Gender:F
Credentials:PTA, LMT, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 PRESTIGE CIR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3438
Mailing Address - Country:US
Mailing Address - Phone:469-656-9826
Mailing Address - Fax:866-529-3789
Practice Address - Street 1:560 PRESTIGE CIR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3438
Practice Address - Country:US
Practice Address - Phone:469-656-9826
Practice Address - Fax:866-529-3789
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2107989225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant