Provider Demographics
NPI:1497427546
Name:DRAKE, LEXI M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEXI
Middle Name:M
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8303 ROCKAWAY ST
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-5221
Mailing Address - Country:US
Mailing Address - Phone:315-717-6541
Mailing Address - Fax:
Practice Address - Street 1:127 E STATE ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1204
Practice Address - Country:US
Practice Address - Phone:518-775-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030899235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist